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The Complete Journal for the Veterinary Health Care Team
CE Credit from Alfred State College, SUNY
Vol. 29 No. 8 | August 2008
HEATHER PRENDERGAST, BS, RVT Racing to Succeed
PARASITOLOGY Canine Tick Paralysis CLINICAL NUTRITION
The Buzz on Nutrigenomics
BEHAVIOR BOOT CAMP
Psychopharmacologic Drugs
Visit us at www.VetTechJournal.com
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Love brings people and pets together. Our recovery system helps them stay that way. Here at AKC Companion Animal Recovery (AKC CAR), we’ve made it our mission to recover as many missing pets as possible. By keeping our ID System microchips affordable, we increase the number of animals who can be found if lost. And we offer prepaid enrollment in our 24/7 recovery service with no annual fees or added charges. But our commitment to animal welfare doesn’t end there: a not-for-profit organization, AKC CAR funds veterinary student scholarships, canine search and rescue grants and disaster relief efforts. To see how AKC CAR is making the world a better place for the animals we share it with, call us toll-free at 1-800-252-7894 or visit www.akccar.org/microchip.
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Editor’sLetter
Vol. 29 No. 8
August 2008
CHIEF TECHNICIAN EDITOR Marianne Tear, MS, LVT EXECUTIVE EDITOR Marie Rosenthal, MS 267-685-2485 | mrosenthal@vetlearn.com MANAGING EDITOR Jill Greshes 267-685-2484 | jgreshes@vetlearn.com ASSISTANT EDITOR Liz Donovan 267-685-2448 | edonovan@vetlearn.com EDITORIAL STAFF C. J. Ellis Paul Basilio VETERINARY ADVISER Dorothy Normile, VMD, Chief Medical Officer SALES AND MARKETING Joanne Carson, National Account Manager 267-685-2410 | 609-238-6147 | jcarson@vetlearn.com Boyd Shearon, Account Manager 913-322-1643 | 215-287-7871 | bshearon@vetlearn.com Linda Costantini, Sales Representative 267-685-2422 | lcostantini@vetlearn.com DESIGN Michelle Taylor, Senior Art Director 267-685-2474 | mtaylor@vetlearn.com David Beagin, Art Director 267-685-2461 | dbeagin@vetlearn.com PRODUCTION Marissa DiCindio, Senior Production Manager 267-685-2405 | mdicindio@vetlearn.com Elizabeth Ward, Associate Production Manager–Journals 267-685-2458 | eward@vetlearn.com CIRCULATION Barbara Horan, Circulation Specialist 267-685-2440 | bhoran@vetlearn.com Gina Donnelly, Customer Service Supervisor 800-426-9119 x2 | info@VetTechJournal.com PUBLISHED BY
780 Township Line Road • Yardley, PA 19067 PRESIDENT Derrick Kraemer EXECUTIVE VICE PRESIDENT Ray Lender 267-685-2417 | rlender@vetlearn.com Indexing: VETERINARY TECHNICIAN ® is included in the international indexing coverage of Index Veterinarius (CAB International), Focus On: Veterinary Science and Medicine (ISI), SciSearch (ISI), and Research Alert (ISI). Article retrieval systems include The Genuine Article (ISI) and The Copyright Clearance Center, Inc. Yearly author and subject indexes for VETERINARY TECHNICIAN are published in December.
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Leading an Award-Winning Journal As you know, VETERINARY TECHNICIAN was redesigned this year to reflect the vital role that we all play in veterinary medicine. We will continue promoting and supporting technicians throughout the industry. Our goal is to increase the recognition of veterinary technicians as vital players on the health care team as well as educate technicians to enable them to provide better care for their patients. We want to enhance the professional image of technicians and hope that we can encourage all technicians to seek certification and continuing education. To reach this goal, I was recently appointed Chief Technician Editor to oversee the editorial content of VETERINARY TECHNICIAN. As program director of the Baker College–Clinton Township Veterinary Technology Program, this is an exciting new role for someone who believes strongly in education. I now have the opportunity to serve as a mentor for the technician students who enter my program as well as a voice for every technician who reads the journal. I promise that we will continue to provide solid, clinical content that you can use in your daily practice. I come to this role at an auspicious time for VETERINARY TECHNICIAN. The publication has a team of editors and writers at Veterinary Learning Systems who are as passionate about the profession as we are, and they were recently rewarded for this passion. For the second year in a row, VETERINARY TECHNICIAN received an APEX Editorial Excellence Award and a second APEX Excellence Award for the redesign of the journal. There were hundreds of entries in each category from publications throughout the United States. I think these honors speak directly to the reason why we are all here — the important role that animals play in all of our lives. As technicians, we are advocates for our patients. We assist the doctor in their diagnosis and treatment. We follow up, educate the owners and promote the best care. Because of our many roles in the clinic, we have more contact with owners than the veterinarian does and we have an opportunity to improve the quality of life of every patient that walks through clinics. I am looking forward to the future and the direction of VETERINARY TECHNICIAN.
Glenn Triest
The Complete Journal for the Veterinary Health Care Team
Marianne Tear, MS, LVT Chief Technician Editor
Veterinary Technician | AUGUST 2008
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Contents
The Complete Journal for the Veterinary Health Care Team
August 2008
Volume 29, No. 8
The peer-reviewed CE articles contained in VETERINARY TECHNICIAN® meet the standards set by Alfred State College for 0.5 credit hour. Documentation will be issued by Alfred State College, a State University of New York (SUNY) College of Technology. All clinical articles are peer reviewed.
Heather Prendergast, BS, RVT
464 Behavior Boot Camp Darren Phillips
460
COLUMNS Understanding Common Psychopharmacologic Drugs Used in Canine Patients Julie Shaw, RVT
478 Equine Essentials Arterial Blood Pressure Monitoring Deborah B. Reeder, RVT
484 Ask the TECHspert Psychogenic Grooming in Cats Deborah (Puppel) Martin, BS, RVT, CPDT
490 Clinical Nutrition The Buzz on Nutrigenomics Kara Burns, MS, MEd, LVT
498 Management Matters Finding the Right Staff Katherine Dobbs, RVT, CVPM, PHR
FEATURE 460
Racing to Succeed — A Talk with Heather Prendergast, BS, RVT Liz Donovan Heather Prendergast is unique among technicians in that she is a shareholder in a veterinary practice. Read about how she was instrumental in opening the first emergency clinic in her area, why she believes it is important for practices to emphasize client education and how she became inspired to train for a marathon to benefit cancer research.
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ON THE COVER Heather Prendergast evaluates a dog as part of her clinic’s weight management program.
See page 460 Cover image: Darren Phillips
www.VetTechJournal.com
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“I want to offer my feline patients the best antioxidant and nutritional support I can. That’s why I recommend Oxstrin Optimized Feline for every senior cat, as well as those experiencing conditions of oxidative stress including retroviral exposure and obesity.” Julia Smith, DVM Baltimore, MD “Bucky’s” veterinarian
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Edgewood, Maryland 21040 1-800-925-5187 nutramaxlabs.com Circle 161 on Reader Service Card
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Contents
August 2008 472 Canine Tick
The Complete Journal for the Veterinary Health Care Team
Volume 29, No. 8
DEPARTMENTS 449 454 456 458 488 497 500 501 501 502 503 512
Paralysis
Editor’s Letter Information Center Tech Views Tech News Tech Tips State News Product Forum Industry Briefs Index to Advertisers Market Showcase Classified Advertising Final View
488
Tech Tips
CE ARTICLE 472
Canine Tick Paralysis Lisa M. Vaughn, LVT Tick paralysis is easily treatable but can be fatal without early intervention. Technicians can educate owners about the clinical signs of the disease and suggest measures to control tick populations and help prevent infestation.
Technicians Mark Milestones Pros and Cons of Various Recruitment Methods (see page 498)
This Month on the Web 452
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Hill’s Pet Wellness Programs Have Positive Impact (see page 501) Microchips — Where to Report a Found Pet (see page 458)
Correction In the July issue’s “Urethral Obstruction in Male Cats,” a typo made a dosage incorrect. The correct bolus dosage for fentanyl is 2–5 µg/kg IV with a constant-rate infusion of 1–5 µg/kg/hr. The updated version appears on our website. We regret any inconvenience this error may have caused. — The Editors
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The potential for an animal poison emergency is always there, so we are too. A pill bottle accidently knocked off a sink. Everyday things can quickly become a poison emergency for a pet. It’s the reason the ASPCA® Animal Poison Control Center is here 24/7/365 to support you with critical recommendations. As the only center in North America dedicated solely to animals, we have an experienced team of board certified veterinary toxicologists* on staff with the special expertise needed to save a pet’s life. Our exclusive AnTox™database of more than one million cases of animal poisonings also gives us immediate access to crucial case information. When potential danger turns into a real emergency, don’t hesitate. Call us.
ORDER A FREE MAGNET Visit www.aspca.org/freemagnet for your free ASPCA Animal Poison Control Center magnet − an easy way to keep our emergency number handy. For information on our online Toxicology CE courses, visit www.apcc.aspca.org. No animals were harmed during the production of this ad.
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*American Board of Veterinary Toxicology www.abvt.org
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InformationCenter
The Complete Journal for the Veterinary Health Care Team
How to Contact Us Want to submit a manuscript? Check on your subscription? Send feedback?
Editorial Office VLS/Veterinary Technician 780 Township Line Road Yardley, PA 19067 Editorial Comments Phone: 800-426-9119, ext. 52446 Email: editor@VetTechJournal.com Fax: 800-556-3288 Submissions Please make sure that your contact information (full name and credentials [if applicable], mailing address, email address, and daytime phone number) is listed clearly on all submissions. Please follow up on submissions if you have not received an acknowledgment from our editorial office within 4 weeks. Manuscript Inquiries and Submissions Phone: 800-426-9119, ext. 52485 Email: mrosenthal@vetlearn.com All Other Editorial Submissions Phone: 800-426-9119, ext. 52446 Email: editor@VetTechJournal.com Fax: 800-556-3288 Tech Tip Videos Visit www.VetTechJournal.com/ sharetechtip to upload your video.
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Our Mission VETERINARY TECHNICIAN is designed to support and actively promote the professional status and value of veterinary technicians and assistants in their own eyes, in the eyes of their colleagues and employers, and within veterinary medicine as a whole. VETERINARY TECHNICIAN® (ISSN 8750-8990) is published monthly by Veterinary Learning Systems, a division of MediMedia USA, 780 Township Line Road, Yardley, PA 19067. Copyright ©2008 Veterinary Learning Systems. All rights reserved. Canada Post international publications mail product (Canadian distribution) sales agreement number 40014103. Return undeliverable Canadian addresses to MediMedia, PO Box 7224, Windsor, ON N9A 0B1. Printed in USA. No part of this issue may be reproduced in any form without written permission from the publisher. Periodicals postage paid at Morrisville, PA, and at additional mailing offices. Subscription rate: $46 for one year, $83 for two years, $119 for three years. Canadian and Mexican rates: $55 for one year, $102 for two years, $142 for three years. Foreign rate: $69 for one year, $126 for two years, $175 for three years. (All checks must be payable to Veterinary Learning Systems in U.S. funds drawn on a U.S. branch of a U.S. bank.) Selected back issues are available for $8 each (plus postage). Reprints are available for all VETERINARY TECHNICIAN articles; call 800-4269119. POSTMASTER: Send address changes to Veterinary Technician, Veterinary Learning Systems, 780 Township Line Road, Yardley, PA 19067.
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EDITORIAL BOARD Elaine Anthony, MA, CVT Kimberly Baldwin, LVT, VTS (ECC) Andrea Battaglia, LVT Dawn Bennett, DVM Tracy Blais, AS, BS, MEd, CVT Kathy Bliss, BS, LVT David Bolette, RVT, LATg Susan Bryant, CVT, VTS (Anesthesia) Melvin C. Chambliss, DVM Mindy Cohan, VMD Christina A. Cornelius, LVT Elizabeth G. Davis, DVM Harold Davis, Jr., BA, RVT, VTS (ECC, Anesthesia) Katherine Dobbs, RVT, CVPM Cheryl Holloway, RVT Tara Lang, BS, RVT Pepi F. Leids, DVM Donna Letavish, CVT Heidi Lobprise, DVM Rosandra (Rose) Manduca, DVM Betty A. Marcucci, VMD, MA Tracey M. Martin, LVT Laura McLain Madsen, DVM Trisha McLaughlin, CVT Kathryn E. Michel, DVM, MS Christopher Norkus, BS, CVT, VTS (ECC, Anesthesia) Jody Nugent-Deal, RVT Kristina Palmer-Holtry, RVT Karl M. Peter, DVM Ann Rashmir-Raven, DVM, MS Virginia Rentko, VMD Nancy Shaffran, RVT, VTS (ECC) Julie Shaw, RVT Margi Sirois, EdD, MS, RVT P. Alleice Summers, DVM Mary Tefend, MS, LVT, VTS (ECC) Kelly Towne-Collins, AAS, LVT Ann Wortinger, LVT, VTS (ECC, SAIM) Any statements, claims, or product endorsements made in VETERINARY TECHNICIAN are solely the opinions of our authors and advertisers and do not necessarily reflect the views of the Publisher or Editorial Board.
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TechViews
Man-made climate change? I was dismayed to read “How Global Warming May Affect the Prevalence of Lyme Disease” (April 2008, page 216) defined global warming as “a phenomenon of worldwide climate change due to human activities,” but it seems that when discussing global climate changes, scientists forget that correlation does not equal causation. Causation has to be proven through thorough, valid scientific testing, and in the matter of the global warming trend, this seems to be easily overlooked by the media and the politicians who all stand to benefit from offering “solutions” to a frightened public. To say that we humans have caused this latest trend is mere correlation. Joyce Boston, RVT Conover, N.C. Response: In the early 1970s, I was taught the theory of global cooling and the possible onset of the next ice age. Global temperatures were observed to be declining at that time. Around the same time, however, the systematic increase in carbon dioxide (CO2) concentration in the atmosphere was first noted. Scientists began to pose questions about the possibility of warming from increasing greenhouse gas concentrations. In the 1980s, an upturn in global temperature was observed, and that trend has continued and accelerated. The observed temperature changes so far have been modest and partially explained by changes in weather observation practices and changes in 456
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land use and population in the vicinity of weather stations across the globe. The warming, however, has continued, and the increase in CO2 concentrations continues at an accelerated rate. Some of my colleagues make strong arguments that this is just another in a long history of natural cycles, but I also have colleagues who are using the scientific method to address causation. They did not jump to quick conclusions. They understood that other factors, such as solar output, changes in the earth’s orbit, the reflectivity of the earth’s surface, volcanic activity and deep ocean heat storage, can contribute to warming or cooling as much as or more than greenhouse gases. They realized that correlation is not the same as causation and that the state-of-the-art global climate models are far from perfect. Using the scientific method, these and many other scientists have been systematically showing that human activities have modified the carbon cycle of the globe. The preponderance of evidence does now point to humans as the primary cause of our current warming, so Dr. McLain Madsen’s statement is justified. However, there is still a place for skepticism. For any observed change, rarely is there just one cause, and rarely do we accurately predict all outcomes. Nolan Doeskin American Association of State Climatologists
Send Us Your Letters Web: www.VetTechJournal.com (Click on Talk to Us to access Editorial Comments.) Email: editor@VetTechJournal.com Fax: 800-556-3288 Mail: VETERINARY TECHNICIAN 780 Township Line Road Yardley, PA 19067 All letters submitted to VETERINARY TECHNICIAN are subject to editing and editorial discretion as to whether they will appear in Tech Views.
Otic Suspension Brief Summary Please consult the full package insert for more information. Indications Acarexx® (0.01% ivermectin) Otic Suspension is indicated for the treatment of adult ear mite (Otodectes cynotis) infestations in cats and kittens four weeks of age or older. Effectiveness against eggs and immature stages has not been proven. Precautions The safe use of Acarexx in cats used for breeding purposes, during pregnancy, or in lactating queens, has not been evaluated. Adverse Reactions In approximately 1% of 80 cats and kittens, pain associated with the pinna and vomiting were observed following treatment with Acarexx. Caution U.S. federal law restricts this drug to use by or on the order of a licensed veterinarian. How Supplied Acarexx is packaged in two polypropylene ampules per foil pouch, which are packaged 12 foil pouches per display carton. Each ampule is filled to deliver 0.5 mL of 0.01% ivermectin otic suspension per ear. Storage Conditions Acarexx should be stored at temperatures below 86°F (30°C). Protect from freezing.
Acarexx is a registered trademark of IDEXX Laboratories, Inc. © 2006 IDEXX Pharmaceuticals, Inc.
IPI/ILS/BS/3
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Just one treatment of Acarexx with patented (0.01% ivermectin) Wisdom technology, DQG KH·V EDFN RQ D UROO ®
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Acarexx® (0.01% ivermectin) is the first and only ivermectin otic suspension approved by the FDA for the treatment of ear mites in cats and kittens as young as 4 weeks old. It’s also the only one with patented Wisdom® technology, which finally makes it possible to deliver the superior efficacy of ivermectin safely. With just one treatment of Acarexx, the little patient will be back to his old tricks.
www.acarexx.com 7009 Albert Pick Rd. Greensboro, NC 27409
See Page 456 for Product Information Summary
© 2008 IDEXX Pharmaceuticals, Inc. • All rights reserved • 4794-02 • Acarexx and Wisdom are registered trademarks of IDEXX Laboratories, Inc. in the United States and/or other countries.
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HomeAgain Releases ISO-Compliant Chip Each year, more than 10 million pets are lost, and without proper identification, 90% are never found. Microchipping increases the odds of a pet being reunited with its owners, but only about 10% of US pets are microchipped, according to Steven Shell, vice president and general manager of Intervet/ScheringPlough HomeAgain. “In 2007 alone, HomeAgain recovered 95,208 cats and dogs through our service,” Shell told VETERINARY TECHNICIAN. “Already in 2008 we are handling lost/found pet cases at a pace of more than 10,000 per month.” HomeAgain recently released a new universal International Organization for Standardization (ISO) microchip with a frequency of 134.2 kHz. Previously, HomeAgain’s microchip carried a frequency of 125 kHz.
In 1996, the ISO developed a standard frequency 134.2-kHz chip to ensure that all chips could be detected when scanned. Although most countries follow the ISO standards, microchips with frequencies of 125 kHz and 128 kHz are available in the United States. At the American Veterinary Medical Association 2007 annual meeting, Shell announced that HomeAgain would distribute scanners that read all three frequencies. He said that 30,000 universal scanners and software to update 9,000 more had been delivered. “Our objective is to get the pet home,” he said, “so we’re trying to eliminate obstacles to microchipping.” For a list of major microchip companies and information about reading the chip or reporting a found pet, visit our website VetTechJournal.com.
New Equine and Behavior Scholarships Honor Veterinary Heroes In August 2006, after the American Association of Equine Veterinary Technicians (AAEVT) Regional Symposium in Lexington, Ky., the veterinary technician community lost a dedicated friend and colleague, Anne Bailey, LVT. Anne was onboard Comair Flight 5191, which went down on takeoff. She was returning home to Canada. In Anne’s honor, the AAEVT has established a scholarship to be funded by proceeds from silent auctions and raffles at regional meetings and at the American Association of Equine Practitioners (AAEP)/AAEVT Annual Convention. The AAEP donated $1,000 toward establishment of the fund. The AAEVT will award up to three scholarships — with a total value of $3,000 — to veterinary technicians, assistants or students. For more information on the award and for an application form, which must be 458
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submitted to the AAEVT by Sept. 30, visit www.aaevt.org. The Academy of Veterinary Behavior Technicians (AVBT) and the Society of Veterinary Behavior Technicians (SVBT) have established the AVBT “Faith” Scholarship to the Karen Pryor Academy for Animal Training and Behavior’s dog trainer program. The scholarship, which is awarded annually, is to be used toward tuition to four workshops taught by Julie Shaw, RVT. The recipient will have demonstrated a commitment to advancing the role of the veterinary technician in the discipline of animal behavior and plans to pursue veterinary technician specialty certification in behavior. The scholarship is named after Faith, the service dog trained for Julie’s son, Dylan, who has cerebral palsy. Faith succumbed to lymphosarcoma at 6 years of age. For details, visit www.svbt.org. www.VetTechJournal.com
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He can’t help it.
You Can. Canine separation anxiety is a distressing disorder for both the dog and its owner. And now you can help dogs overcome separation anxiety with Reconcile™. Studies show that taken once daily, Reconcile™ chewable tablets combined with the BOND™ behavior modification plan helps provide more successful outcomes when treating separation anxiety. Matthew Wheaton, DVM Alicia Pet Care Center Mission Viejo, Calif.
“Reconcile™ is a great addition to my practice. It has made an impact on dogs suffering from separation anxiety, and my clients are happy with the results.”
N
In a recent independent study, 100% of veterinarians using Reconcile™ were satisfied with its performance. (Reconcile™ Awareness & Usage Study, December 2007)
To find out how you can improve the lives of your canine patients, visit www.reconcile.com or contact us at 1 (888) LillyPet.
Circle 193 on Reader Service Card The most common adverse reactions recorded during clinical trials were calm or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and, in infrequent cases, seizures. For product label, including important safety information, see page 458. ©2008 Eli Lilly and Company RE00186 070108
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Heather relaxes with her red heeler, Taylor.
Darren Phillips
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Racing to Succeed A Talk with Heather Prendergast, BS, RVT
H
eather Prendergast, BS, RVT, never stops running.
Liz Donovan Assistant Editor
Whether she’s darting to one of her three jobs or training for a marathon, Heather proves that there is no limit to what veterinary technicians can accomplish. In her role as practice manager and head technician at Jornada Veterinary Clinic in Las Cruces, N.M., Heather strives to ensure that the clinic offers the highest-quality care and emphasizes client education. Her drive to improve veterinary health care in her community led to her working with 11 shareholders to open Veterinary Emergency Services, the first emergency hospital in Las Cruces. She now oversees the management of the hospital and acts as secretary and treasurer of the shareholder’s corporation. In addition to her work in private practice, Heather represents Nestlé Purina PetCare Company as a nutritional consultant, educating pet owners and veterinary professionals about animal nutrition. Here, she tells us about her upcoming book on veterinary practice management, her plans to create a nutrition specialty academy for technicians and her motivation to run a 13-mile race in honor of a friend with leukemia.
Darren Phillips
Until we opened Veterinary Emergency Services in 2005, our community didn’t have an emergency hospital, and the staff at the nine veterinary clinics in our community were finding it difficult to see emergency cases. With the help of another investor, I researched the specifics of opening a facility. We invited local veterinarians to a meeting to discuss this possibility, and then 12 of us decided to invest in the new company. Because I spearheaded the process, I became president of the shareholder’s corporation. The shareholders put a lot of faith in me to make decisions regarding how the hospital was run, so I did most of the initial work. My experience as both a manager and a technician worked to my advantage because I knew what types of equipment and drugs we would need to buy, how to create and maintain a budget and how to hire and motivate an excellent health care team. My term as president ended in 2007, but I am now the secretary and treasurer of the corporation. I continue to handle the budget and assist in managing the hospital. www.VetTechJournal.com
PERSONAL INTEREST
Runner with a Cause
A
fter a full workday, there’s nothing that Heather loves more than a long run. She runs 5 days a week to keep in shape for half marathons, which she participates in once a year. “Running is a great stress reliever,” says Heather, who enjoys running with a partner so that she can use the time to discuss her day. “I’m not too much of a competitive person when it comes to running. My personal goal is to enjoy myself and improve my fitness level.” Heather’s running goals recently reached beyond her own health after she learned that her good friend and gym partner was diagnosed with leukemia. The University of New Mexico Cancer Center treated her friend, who is now in remission, and absorbed most of the medical costs. Inspired by her friend’s recovery, Heather has set a goal to train for a half marathon through the Leukemia and Lymphoma Society’s Team in Training program, which raises money for cancer research. “Research saved my friend’s life. Through Team in Training, I can give back to cancer research so that another leukemia patient will survive,” says Heather. The marathon will take place in January in Phoenix, Ariz. For more information about Team in Training, visit Heather (left) runs a half marathon with Nancy Soules, DVM, who owns Jornada www.teamintraining.org. Veterinary Clinic. Veterinary Technician | AUGUST 2008
The San Francisco Marathon
You were instrumental in starting your community’s first emergency hospital. Tell us about that experience.
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Racing to Succeed What are your goals as practice manager and head technician at Jornada?
Want to know more about Heather? Submit your question at VetTechJournal.com/ttqa. You may see Heather’s answer in a future issue of our e-newsletter, TechTalk.
Chris Delgado
On the Web!
I concentrate on providing high-quality medical care to our patients. Several years ago, I left Jornada for 6 months to work as a veterinary sales representative. During that time, I visited a number of veterinary clinics to help them provide the best medical care possible to their patients. That experience motivated me to return to Jornada, where I was able to treat patients with a high standard of care. Although Jornada was already an excellent clinic, I felt that we needed to spend more time educating clients.
Heather discusses nutrition with a credentialed veterinary technician while at a conference.
As a nutritional consultant for Nestlé Purina, you educate pet owners as well as veterinary professionals about veterinary nutrition. Why is this topic important?
What changes did you make regarding client education? I created client education programs because I believe clients should be informed about all aspects of their pet’s care. Clients are only going to understand how you’re treating their pet if you take the time to educate them. We want them to be confident that we use aseptic techniques and the most advanced monitoring equipment and surgical procedures. The technicians at Jornada spend significant time talking with the client at each visit. When owners bring in a new puppy, we talk to them about microchipping and spaying or neutering. We also emphasize the client’s role in maintaining the pet’s health through proper dental care and nutrition. Then, we give our clients pamphlets to take home so they can refer to them later to remember what we discussed.
VITAL STATISTICS HEATHER PRENDER GAST BS in animal science, New Mexico State University, Las Cruces (1996); AS in veterinary technology, St. Petersburg College, St. Petersburg, Fla. (2000)
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Darren Phillips
Professional Associations
Pets
Do you have any other projects on the horizon? I have a contract to write a book for Elsevier, which I’m really excited about. It will be 26 chapters on administrative issues for practice managers and will cover many topics, such as how to fill out tax forms for employees and how to develop client education and staff education programs. Writing this book is probably my biggest accomplishment so far.
You have already accomplished so many goals. What advice can you offer to technicians who are just starting out in the profession?
Education
Member of NAVTA, the New Mexico Registered Veterinary Technicians Association and the Veterinary Hospital Managers Association
Because technicians play such a large role in client education, it’s important that they understand all aspects of nutrition, including what is recommended for each life stage of the animal and how nutrition can benefit animals that have certain diseases. Technicians can explain the dangers of obesity and kidney disease, both of which can be managed with a proper diet, medications and/or other therapeutic interventions. When we educate clients, they will know how to feed their pet so it can live a longer, healthier life.
Be active in preventing burnout. I’ve seen a lot of new technicians start out with a great work ethic but then work too many hours and lose interest in the profession. To prevent this from happening, look for opportunities to continuously challenge yourself, like becoming specialized. Identify how you can improve your clinic and how your skill set can benefit the practice. Most important, take continuing education courses so you can improve your skills, grow as a professional and provide the best care possible. www.VetTechJournal.com
Merial-Vaccines_USE.qxp:VT
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THE ONLY NONADJUVANTED LEUKEMIA VACCINE
YOU KNOW the concerns associated with adjuvanted feline leukemia vaccines.
WE KNOW how to protect with a nonadjuvanted recombinant feline vaccine. Nonadjuvanted PUREVAX® Recombinant Leukemia vaccine and the VET JET™ transdermal vaccination system provide enhanced immune response1 through targeted antigen presentation. • Nonadjuvanted • Recombinant technology • Humoral and cell-mediated immunity1 1
El Garch H, Richard S, Piras F, Leard T, Poulet H, Andreoni C, Juillard V. Feline Leukemia Virus (FeLV) – Specific IFNÁ+ T-Cell Responses Are Induced in Cats Following Transdermal Vaccination With a Recombinant FeLV Vaccine. Intern J Appl Res Vet Med 2006; 4(2):100-108. ®PUREVAX is a registered trademark, and ™VET JET is a trademark, of Merial. ©2008 Merial Limited, Duluth, GA. All rights reserved. PUR07PBFELVONEPGAD.
• Enhanced immunity1 Please contact your Merial Sales Representative, Merial Sales Agent,or call Merial Customer Care at 1-888-Merial-1.
Your knowledge. Our science. Their health. Circle 175 on Reader Service Card
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BehaviorBootCamp
Understanding Common
Julie Shaw, RVT Purdue University West Lafayette, Ind.
Psychopharmacologic Drugs Used in Canine Patients
A
LTHOUGH PSYCHOACTIVE med-
©2008/Felicia Paras
ications are useful in treating behavior problems — especially anxiety disorders — it is rare for medication alone to be successful. In most cases, success also requires environmental changes and behavior modification.
Basic Brain Physiology and Chemistry Hundreds of thousands of chemical and electrical reactions, which are the foundation for thoughts and behavior, occur in the brain every moment. As a veterinary technician, you should have basic knowledge of how the brain transmits information to understand a pet’s behavior problems. Understanding these processes may help you encourage owners to pursue pharmacologic treatment and behavior modification for their pet’s behavior problems. Just as microprocessors transmit information to other microprocessors, neurons in the brain send and receive information among other neurons. The neuron has both short and long appendages. The short branch-like appendages, called dendrites, extend from the cell body and receive information from outside the cell. Much longer appendages, called axons, carry messages from the neuron. Near its end, the axon divides into many fine tributaries that end in a knob called the axon terminal or presynaptic terminal, which is where the axon passes information to other neurons. The site where the axon terminal makes contact with another neuron’s dendrite is called the synapse, which in Greek means “to fasten together.” The synapse is where presynaptic and postsynaptic neurons communicate with each other. An average neuron forms thousands of synapses with other neurons in response to life experiences. Neurons communicate by using chemical and electrical messages. Electrical impulses are sent down the axon of the presynaptic neuron to the axon’s terminal but once there cannot cross the synaptic space. The electrical impulse triggers chemicals, called neurotransmitters, which can cross to the postsynaptic cell. With(continues on page 467) 464
AUGUST 2008 | Veterinary Technician
The technician, therefore, can work with owners on obtaining a complete behavior and medical history before the veterinarian considers prescribing a behavior drug. Because most of these drugs are metabolized through the kidneys and liver, preliminary baseline information on kidney and liver function always should be obtained.1 Most psychoactive medications are used off-label for animals. Only a few medications, such as fluoxetine (Reconcile, Lilly) and clomipramine (Clomicalm, Novartis Animal Health), are indicated for specific use in dogs. A valid veterinarian–client–patient relationship must exist when prescribing psychoactive medications. As a technician, you play a significant role in this relationship by being the “eyes and ears” of the veterinarian. You should stay in contact with the client to ensure that the medication is being given properly and to assess the animal’s progress. Detailed reports, including any adverse events or owner concerns, need to be communicated to the veterinarian. You can explain to the owner that the veterinarian will select a drug by considering the pet’s species, health status, drug history, and diagnosis; the drug’s side effect profile and contraindications; and published studies. The drug classes frequently used in veterinary medicine include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and benzodiazepines.
SSRIs SSRIs are a class of antidepressants that inhibit the reuptake of serotonin into the presynaptic neuron. This leads to an increase in the amount of serotonin in the synaptic space. www.VetTechJournal.com
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Dr. Pay
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Pfizer-Dexdomitor_Lgl_USE.qxp:VT
NADA 141-267, Approved by FDA.
(dexmedetomidine hydrochloride) Sterile Injectable Solution – 0.5 mg/mL For intramuscular and intravenous use in dogs and for intramuscular use in cats CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: DEXDOMITOR is indicated for use as a sedative and analgesic in dogs and cats to facilitate clinical examinations, clinical procedures, minor surgical procedures, and minor dental procedures. DEXDOMITOR is also indicated for use as a preanesthetic to general anesthesia in dogs. CONTRAINDICATIONS: Do not use DEXDOMITOR in dogs or cats with cardiovascular disease, respiratory disorders, liver or kidney diseases, or in conditions of shock, severe debilitation, or stress due to extreme heat, cold or fatigue. As with all alpha2-adrenoceptor agonists, the potential for isolated cases of hypersensitivity, including paradoxical response (excitation), exists. HUMAN WARNINGS: Not for human use. Keep out of reach of children. Dexmedetomidine hydrochloride can be absorbed following direct exposure to skin, eyes, or mouth, and may cause irritation. In case of accidental eye L_WVZ\YL Å\ZO ^P[O ^H[LY MVY TPU\[LZ 0U JHZL VM accidental skin exposure, wash with soap and water. Remove contaminated clothing. Appropriate precautions should be taken while OHUKSPUN HUK \ZPUN ÄSSLK Z`YPUNLZ (JJPKLU[HS [VWPJHS (including ocular) exposure, oral exposure, or exposure by injection could cause adverse reactions, including sedation, hypotension, and bradycardia. Seek medical attention immediately. Users with cardiovascular disease (for example, hypertension or ischemic heart disease) should take special precautions to avoid any exposure to this product. Caution should be exercised when handling sedated animals. Handling or any other sudden stimuli, including noise, may cause a defense reaction in an animal that appears to be heavily sedated. The material safety data sheet (MSDS) contains more detailed occupational safety information. To report adverse reactions in users or to obtain a copy of the 4:+: MVY [OPZ WYVK\J[ JHSS Note to physician: This product contains an alpha2adrenergic agonist. PRECAUTIONS: For cats, the concurrent use of DEXDOMITOR prior to or with an anesthetic has not been evaluated. Dexmedetomidine in cats has not been evaluated in the presence of other sedatives. Dexmedetomidine sedation is not recommended for cats with respiratory disease. Adverse reaction reports for dexmedetomidine include a cat with severe dyspnea and respiratory crackles diagnosed as acute pulmonary edema. The cat’s health history was not known and the cat recovered with treatment. (S[OV\NO UV[ VIZLY]LK PU [OL MLSPUL ÄLSK Z[\K` ^P[O dexmedetomidine, rare cases of delayed pulmonary edema, some resulting in death, have been reported in cats that received medetomidine (another alpha2agonist), usually in conjunction with anesthesia. In these cases, dyspnea due to the delayed onset of pulmonary edema developed up to 3 days after medetomidine administration. Dexmedetomidine should not be administered in the presence of preexisting hypotension, hypoxia, or bradycardia. Due to the pronounced cardiovascular effects of dexmedetomidine, only clinically healthy dogs and cats should be treated. Animals should be frequently monitored for cardiovascular function and body temperature during sedation or anesthesia. Intramuscular ANTISEDAN (atipamezole) may be routinely used to rapidly reverse the effects of dexmedetomidine in dogs. Since analgesic as well as sedative effects will be reversed, pain management may need to be addressed. In the event of apnea, accompanied by bradycardia and cyanotic mucous membranes, additional oxygen should be supplied. Administration of ANTISEDAN (atipamezole) to dogs exhibiting these signs is warranted. Atipamezole has not been evaluated as a routine dexmedetomidine reversal agent in cats. A decrease in body temperature is likely to occur during sedation with dexmedetomidine unless externally maintained. Once established, hypothermia may persist longer than sedation and analgesia. To prevent hypothermia, treated animals should be kept warm and at a constant temperature during the procedure, and until full recovery. Nervous or excited animals with high levels of endogenous catecholamines may exhibit a reduced pharmacological response to alpha2-adrenoceptor agonists like dexmedetomidine. In agitated animals, the
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onset of sedative/analgesic effects could be slowed, or the depth and duration of effects could be diminished or nonexistent. Therefore, allow dogs and cats to rest X\PL[S` MVY [V TPU\[LZ HM[LY PUQLJ[PVU 9LWLH[ dosing has not been evaluated. Reversible corneal opacity may occur during sedation in cats. An eye lubricant should be applied to prevent corneal desiccation that may result from a reduction PU [OL ISPUR YLĂ…L_ K\YPUN ZLKH[PVU Spontaneous muscle contractions (twitching) can be expected in some dogs sedated with dexmedetomidine. The use of dexmedetomidine as a preanesthetic in KVNZ ZPNUPĂ„JHU[S` YLK\JLZ [OL HTV\U[ VM PUK\J[PVU and maintenance anesthetic requirements. Careful patient monitoring during anesthetic induction and maintenance is necessary to avoid anesthetic overdose. Analgesia resulting from preanesthetic dexmedetomidine in dogs is dose-dependent, and may not provide adequate pain control during the postoperative or postprocedural period. Additional pain management should be addressed as needed. Administration of anticholinergic agents in dogs at the same time or after dexmedetomidine could lead to adverse cardiovascular effects (secondary tachycardia, prolonged hypertension, and cardiac arrhythmias). However, an anticholinergic drug may be administered at least 10 minutes before dexmedetomidine for the prevention of the dexmedetomidine-induced reduction in heart rate. Therefore, the routine use of anticholinergics simultaneously with, or after dexmedetomidine in dogs, is not recommended. The use of anticholinergics in the presence of dexmedetomidine has not been evaluated in cats. Dexmedetomidine has been evaluated only in fasted dogs; therefore, its effects on fed dogs (for example, the occurrence of vomiting) have not been characterized. In cats, there is a high frequency of vomition whether fed or fasted; therefore, fasting is recommended to reduce stomach contents. Dexmedetomidine has not been evaluated in dogs younger than 16 weeks of age, in cats younger than 12 weeks of age, or in geriatric dogs and cats. Dexmedetomidine has not been evaluated for use in breeding, pregnant, or lactating dogs or cats. ADVERSE REACTIONS: Canine sedation/analgesia field study: In the Ă„LSK Z[\K` safety analysis, 106 dogs received dexmedetomidine and 107 received medetomidine. Dogs ranged from 16 weeks to 16 years of age, representing 49 breeds. The following table shows the number of dogs displaying each clinical observation (some dogs experienced more than one adverse reaction). Table 4: Adverse reactions during the canine sedation/ HUHSNLZPH Ă„LSK Z[\K` Dexmedetomidine Medetomidine Total n=106 Total n=107
Severe bradycardia
0
0
1
0
0
1
Tachycardia
0
0
0
1
1
0
Diarrhea
1
0
0
3
1
1
Emesis
4
7
4
2
3
6
Urinary incontinence
0
0
0
0
0
1
Self trauma
0
2
1
2
1
0
Other clinical signs observed in dogs treated with dexmedetomidine include decreased respiratory rate and hypothermia. Feline sedation/analgesia field study: The field study safety analysis included 242 cats (122 received dexmedetomidine; 120 received _`SHaPUL [V `LHYZ VM HNL HUK YLWYLZLU[PUN 19 breeds. The following table shows the number of cats reported with an adverse reaction (some cats experienced more than one adverse reaction). Table 6: Adverse reactions during the feline Ă„LSK Z[\K` Dexmedetomidine Xylazine n=122 n=120 Vomiting
70
82
Urinary incontinence
6
11
Hypersalivation
4
Involuntary defecation
4
1
Hypothermia
2
1
Diarrhea
2
0
Arrhythmia
1
2
Corneal ulcer
1
0
Cyanosis
1
0
Dyspnea
1
0
The most frequently observed adverse reaction was vomiting in both fasted and fed cats. Other infrequent clinical signs observed in cats treated with dexmedetomidine included fatigue, anorexia, cystitis, and peripheral vascular disorder. One incidence of dyspnea was reported, 43 minutes after dexmedetomidine administration during an oral examination/dental procedure. Prior to dexmedetomidine, the cat was free of clinical signs, but had a history of asthma and respiratory infection. The cat responded successfully to treatment. INFORMATION FOR OWNERS: Due to the rare possibility of delayed onset of pulmonary edema which has been associated with administration of other alpha2adrenergic agonists in cats, animal owners should notify their veterinarian immediately if their cat experiences KPMÄJ\S[` IYLH[OPUN STORAGE INFORMATION: Store at controlled YVVT [LTWLYH[\YL ‡* ‡- 7YV[LJ[ MYVT freezing.
(\ZJ\S[LK \UPKLU[PĂ„LK arrhythmias
19
20
Severe bradycardia requiring treatment
1
1
Apnea requiring treatment
1
0
HOW SUPPLIED: DEXDOMITOR is supplied in 10-mL, T\S[PKVZL ]PHSZ JVU[HPUPUN TN VM KL_TLKL[VTPKPUL hydrochloride per mL.
Slow onset of sedation (exceeding 30 minutes)
1
1
U.S. Patent No. 4,910,214 DEXDOMITORÂŽ is a trademark of Orion Corporation.
Ineffectiveness (dog standing throughout the study)
3
2
2
0
Prolonged recovery
1
4
Orion Pharma Orion Corporation Espoo, Finland
;HISL ! (K]LYZL YLHJ[PVUZ K\YPUN [OL JHUPUL WYLHULZ[OLZPH Ă„LSK Z[\K`
+P] VM 7Ă„aLY 0UJ NY, NY 10017
PRECAUTIONS: 1. Handling: Antisedan can produce an abrupt reversal of sedation; therefore, dogs that have recently received Antisedan should be handled with caution. The potential for apprehensive or aggressive behavior should be considered in the handling of dogs emerging from sedation, especially in dogs predisposed to nervousness or fright. Also, avoid situations where a dog might fall. 2. Sedation relapse: While atipamezole does reverse the clinical signs associated with medetomidine or dexmedetomidine sedation, complete physiologic return to pretreatment status may not be immediate or may be temporary, and dogs should be monitored for sedation relapse. Sedation relapse is more likely to occur in dogs that receive an alpha2-agonist by the IV route, compared to dogs that are sedated using the IM route. Animals should be monitored closely for persistent hypothermia, bradycardia, and depressed respiration, until signs of recovery persist. 3. Analgesia reversal: Atipamezole reverses analgesic effects as well as sedative effects. Additional procedures for the control of pain may be required. 4. Debilitated dogs: The safety of atipamezole has not been evaluated in dogs with compromised health. Geriatric, debilitated, and ill dogs are more likely to experience adverse reactions associated with the administration of alpha2-antagonists (as well as alpha2agonists). Dogs with abnormalities associated with the cardiovascular system are especially at risk. Breeding dogs: Antisedan has not been evaluated in breeding dogs; therefore, the drug is not recommended for use in pregnant or lactating dogs, or in dogs intended for breeding. 6. Minimum age and weight: Antisedan has not been evaluated in dogs less than 4 months of age or in dogs weighing less than 4.4 lbs (2 kg).
STORAGE INFORMATION: Store protected from SPNO[ H[ JVU[YVSSLK YVVT [LTWLYH[\YL ‡œ ‡* ‡œ ‡-
Distributed by:
;OL VJJ\YYLUJL VM H\ZJ\S[LK \UPKLU[PĂ„LK HYYO`[OTPHZ (some at multiple time points) decreased following the administration of atipamezole. Canine preanesthesia ďŹ eld study: The preanesthesia Ă„LSK Z[\K` ZHML[` HUHS`ZPZ PUJS\KLK KVNZ IL[^LLU TVU[OZ HUK `LHYZ VM HNL YLWYLZLU[PUN IYLLKZ enrolled for elective procedures conducted under general anesthesia. The following table shows the number of dogs within a treatment group that showed each clinical sign (some dogs experienced more than one adverse reaction).
HUMAN WARNINGS: Not for human use. Keep out of reach of children.Atipamezole hydrochloride can be absorbed and may cause irritation following direct exposure to skin, eyes, or mouth. In case of accidental L`L L_WVZ\YL Ă…\ZO ^P[O ^H[LY MVY TPU\[LZ 0U JHZL of accidental skin exposure, wash with soap and water. Remove contaminated clothing. If irritation or other adverse reaction occurs (for example, increased heart rate, tremor, muscle cramps), seek medical attention. In case of accidental oral exposure or injection, seek medical attention. Caution should be used while OHUKSPUN HUK \ZPUN Ă„SSLK Z`YPUNLZ Users with cardiovascular disease (for example, hypertension or ischemic heart disease) should take special precautions to avoid any exposure to this product. The material safety data sheet (MSDS) contains more detailed occupational safety information. To report adverse reactions in users or to obtain a copy VM [OL 4:+: MVY [OPZ WYVK\J[ JHSS Note to Physician: This product contains an alpha2adrenergic antagonist.
ADVERSE REACTIONS: Occasional vomiting may occur. At times, a period of excitement or apprehensiveness may be seen in dogs treated with atipamezole. Other effects of atipamezole include hypersalivation, diarrhea, and tremors.
Mfd by:
Severe hypothermia requiring treatment
CONTRAINDICATIONS: Since atipamezole is always used concomitantly with dexmedetomidine or medetomidine, it should not be used in dogs with the following conditions: cardiac disease, respiratory disorders, liver or kidney diseases, dogs in shock, severely debilitated dogs, or dogs stressed due to extreme heat, cold or fatigue. Administration of atipamezole is contraindicated in dogs with a known hypersensitivity to the drug.
November 2007
HOW SUPPLIED: Antisedan is supplied in 10-mL, T\S[PKVZL ]PHSZ JVU[HPUPUN TN VM H[PWHTLaVSL hydrochloride per mL. < : 7H[LU[ 5VZ
NADA #141-033, Approved by FDA
" "
AntisedanÂŽ, DexdomitorÂŽ, and DomitorÂŽ are trademarks of Orion Corporation.
(atipamezole hydrochloride) Developed and manufactured by:
Treatment Groups Induction Anesthetic:
Propofol
Sterile Injectable Solutionâ&#x20AC;&#x201D;5.0 mg/mL
Barbiturate
Dexmedetomidine and Medetomidine Reversing Agent
Preanesthetic 0 0 Dose: mcg/ mcg/ mcg/ mcg/ mcg/ mcg/ m2 m2 m2 m2 m2 m2 n=32 n=32 n=32 n=32 n=32 n=32 Ventricular premature contractions
0
2
0
4
1
0
For intramuscular use in dogs only CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: Antisedan is indicated for the reversal of the sedative and analgesic effects of Dexdomitor (dexmedetomidine hydrochloride), and Domitor (medetomidine hydrochloride) in dogs.
Distributed by:
+P] VM 7Ă&#x201E;aLY 0UJ NY, NY 10017 November 2007
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BehaviorBootCamp
Side effects: Decreased appetite Increased anxiety or activity Insomnia Transient sedation Seizures (occur infrequently)
Notes: May take 4 to 6 weeks for full effect, although a decrease in anxiety is often observed sooner Never use with an MAOI Contraindications: Patients receiving tryptophan — make sure clients are not giving as an over-the-counter additive Breeding or pregnant animals Patients receiving warfarin or digitoxin
©2008/Felicia Paras
Although classified as antidepressants, SSRIs also have been shown to have anticompulsive and antiaggressive effects. Fluoxetine has been used most commonly in the treatment of behavior problems in companion animals, particularly those with anxiety disorders, such as separation anxiety and aggression. One of the many advantages of fluoxetine is that it should not impair the animal’s
learning process, a benefit if implementing a behavior modification plan.2 Compared with other antidepressants, such as the TCAs, SSRIs have relatively few side effects. The most common side effect reported by owners is transient sedation and decreased appetite. Technicians should monitor the duration of decreased appetite, weigh the patient to determine if weight loss is an issue, and communicate recommendations for increasing the palatability of the patient’s food. Increased agitation can occur, but it is rare. As the technician, you should discuss any reports of increased activity or trembling with the veterinarian. You also should report less common side effects, such as vomiting, diarrhea, insomnia, and decreased sexual motivation in breeding animals. SSRIs are most commonly given once daily. Transdermal administration of fluoxetine to cats has been shown to be an ineffective route of administration.3 It is important to advise owners that although they may see some changes in behavior within a week, the full effect may not be known until 4 to 6 weeks into treatment. An SSRI, such as fluoxetine, is metabolized primarily by the liver, and elimination is significantly delayed in animals with liver disease. Therefore, a decreased dose should be considered for these patients.4
Basic Brain Physiology and Chemistry (continued from page 464)
out neurotransmitters, the electrical impulse would sputter out. Instead, the neurotransmitters travel through the synaptic space and are received in highly specialized receptor sites on the dendrite. The receptor sites on the postsynaptic neuron and neurotransmitters can be compared to puzzle pieces. Communication between the neurons depends on the puzzle pieces (neurotransmitter and receptor) fitting together, generating an electrical impulse that travels down the dendrite toward the cell body. Once the neurotransmitter has accomplished its mission, it is released back into the synaptic space and may travel back to the presynaptic neuron to be recycled. This process of “returning back” is called reuptake. If the neurotransmitter is not taken back into the presynaptic neuron, it is degraded by enzymes while still in the synaptic space. These enzymes control the amount of neurotransmitters left in the synaptic space, preventing a “traffic jam” at the postsynaptic neuron’s receptor sites.5–7 Neurotransmitters — The Big Four Neurotransmitters are the chemicals in the brain that transmit information from one neuron to another.6 Four common neurotransmitters are: Serotonin (5-HT): Serotonin regulates emotion, anxiety, agitation, and sleep. Decreased amounts of serotonin increase irritability, hostility, and impulsiveness, whereas increased amounts of serotonin increase confidence, calmness, and resilience.3
www.VetTechJournal.com
Only 1% to 2% of the body’s serotonin content is found in the brain.1 Heavy concentrations of serotonin also are found in the gastrointestinal (GI) tract, where it is involved in bowel motility. Therefore, any drug affecting serotonin function could change psychological processes in the brain as well as functioning of the GI tract. The synthesis of serotonin occurs in two steps: Tryptophan is converted into 5-hydroxytryptophan (5-HTP) and then into serotonin. This is important to understand because a decrease in dietary tryptophan can lead quickly to a deficiency of serotonin in the brain.5 Norepinephrine (noradrenaline):Like serotonin, norepinephrine regulates mood, emotion, attention, and information processing. Decreased amounts of norepinephrine are associated with depression, whereas increased amounts of norepinephrine are associated with increased mania. Like serotonin, norepinephrine is found throughout the body. It also seems to play a key role in the performance of the autonomic nervous system.6 Dopamine: Dopamine is synthesized from norepinephrine and affects three important aspects of behavior: motor control, emotions, and addiction. A decrease in dopamine causes calmness and depression, and an increase in dopamine has been found in stereotypic behaviors,5–7 such as repetitive tail chasing. Gamma-aminobutyric acid (GABA): GABA is the brain’s primary inhibitory neurotransmitter and inhibits the postsynaptic neuron from firing. It is the most common neurotransmitter in the brain. Seizure activity may be associated with a decrease in GABA levels.2,4–6
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BehaviorBootCamp MAOIs (monoamine oxidase inhibitors) should never be used with fluoxetine because they also inhibit the reuptake of serotonin in presynaptic neurons, which could cause a lifethreatening overdose of serotonin called serotonin syndrome.2,4
Side effects: Dry mouth Constipation Diarrhea Decreased tear production Urinary retention Sedation Cardiac arrhythmias, such as tachycardia Changes in blood pressure
Notes: May take 3 to 4 weeks for full effect Withdrawal from the medication should be gradual Acute withdrawal could cause a rebound effect of increased anxiety Contraindications: Geriatric patients Patients with compromised liver function Patients with cardiac abnormalities Patients prone to seizures Patients with glaucoma Patients being treated for thyroid disease
Benzodiazepines are anxiolytics — antianxiety agents — with rapid onset and a duration of activity of a few hours or more. They are useful for problems involving anxiety in which rapid onset is desired. Their immediate efficacy makes them particularly useful for treating animals with fear induced by a recognizable and specific stimuli that can be predicted. The medication can be administered an hour before the trigger, such as fireworks or a trip to the veterinarian. Benzodiazepines are preferred over tranquilizers, such as acepromazine, because they provide a significant decrease in anxiety without pronounced sedation, making the animal more receptive to behavior modification techniques. Because of their quick onset, benzodiazepines often are used with antidepressants. Using a combination often will decrease signs while the antidepressant reaches therapeutic levels. The lasting effect of benzodiazepines is highly variable among patients and among each benzodiazepine. Although benzodiazepines sometimes decrease aggressiveness, they can also increase aggression in some cases. Relief from anxiety can result in the loss of inhibition of behavior, comparable with the effects of alcohol in humans. Therefore, the use of benzodiazepines in pets with known aggression remains controversial. Benzodiazepines should be withdrawn gradually over several weeks in patients that have received frequent doses. Tolerance often develops over time, so steadily increased doses may be required to achieve the desired effect.2,4
TCAs
Conclusion
TCAs block the reuptake of norepinephrine and serotonin, causing an increase in availability of serotonin, norepinephrine, and dopamine. Commonly used TCAs include clomipramine and amitriptyline. Some TCAs, especially amitriptyline, have antihistaminic effects. Most TCAs are metabolized by the liver to an intermediate metabolite before excretion through the kidneys. Therefore, they should be used cautiously in geriatric patients or in patients with compromised liver function. Anticholinergic side effects are common and include dry mouth, constipation, urinary retention, tachycardia, and sedation. Inappetence and gastrointestinal (GI) upset are also common. TCAs may lower the seizure threshold and may block sodium channels to the heart, leading to cardiac arrhythmias. TCAs are contraindicated in pets with preexisting cardiac disease, seizures, glaucoma, or liver disease. They can also interfere with the control of thyroid disease.1,4
Pet owners may be hesitant to place their pet on psychopharmacologic medications. As a veterinary technician,
Benzodiazepines Benzodiazepines, such as alprazolam, clonazepam, lorazepam, and diazepam, are gamma-aminobutyric acid (GABA) agonists. An agonist causes the receptor to function as if it were bound by a naturally occurring neurotransmitter. 468
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Side effects: Hyperphagia — you should advise owners that this can be extreme in some cases, although it may be beneficial when the benzodiazepine is being combined with an SSRI that is likely to cause temporary inappetence Muscle relaxation Decreased locomotor activity Varying degrees of sedation Possible disinhibition of aggression — the veterinarian may ask you to instruct the owner on how to desensitize and countercondition a basket muzzle if this is a potential concern
Paradoxical excitation Notes: Some anticonvulsant properties Fast acting Has the potential for abuse by owners taking the medication themselves — report any such concerns to the veterinarian
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References
The Misuse of Tranquilizers in the Treatment of Behavior Problems
1. Overall K. Paradigms for pharmacologic use as a treatment component in feline behavioral medicine. J Feline Med Surg 2004;6:29-42. 2. Hedges D, Burchfield C. Mind, Brain, and Drug: an Introduction to Psychopharmacology. Boston, Mass.: Pearson Education, Inc.; 2006:3-46. 3. Ciribassi J. Comparative bioavailability of fluoxetine after transdermal and oral administration to healthy cats. Am J Vet Res 2003;64:8. 4. Crowell-Davis S, Murray T. Veterinary Psychopharmacology. Ames, Iowa: Blackwell Publishing; 2006:3-25, 72-110, 119-147, 179-206. 5. Bear M. Neuroscience: Exploring the Brain. Baltimore, Md.: Lippincott Williams & Wilkins; 2007:23-48. 6. Landsberg G, Hunthausen W, Ackerman L. Handbook of Behavior Problems of the Dogs and Cat, ed 2. London: Elsevier; 2003:117-151. 7. Levinthal C. Drugs, Behavior, and Modern Society, ed 5. Boston, Mass.: Pearson Education, Inc.; 2008:76.81.
Tranquilizers, such as acepromazine, decrease spontaneous activity, resulting in decreased response to stimuli, but profoundly interfere with the application of behavior modification techniques and, most important, do not decrease the animal’s anxiety. The behaviors associated with anxiety, such as pacing and vocalizing, may be decreased, but the emotionality has not been changed. Tranquilizers are often misused in a fearful animal without addressing the true underlying issue of anxiety. This has the potential of leaving an anxious and uncertain animal less able to cope with its anxiety. Acepromazine may make an animal more reactive to noises and cause it to startle more easily, so its use may be inappropriate in some cases .1 you can significantly reduce the anxiety of pet owners by helping them understand how the prescribed medications work to alleviate their pet’s behavior problems. Ensuring that clients understand that their pet’s anxiety has an organic component, just like any other medical condition, may decrease the stigma of including medication in the pet’s behavioral treatment plan.
Julie Shaw, RVT Julie has been the senior animal behavior technologist at Purdue University’s Animal Behavior Clinic since 1999. She currently organizes and helps teach Purdue’s popular DOGS! course on behavior modification principles and techniques, lectures to veterinary professionals nationally and internationally, is the chairwoman of the organizing committee for the Academy of Veterinary Behavior Technicians, and is on the faculty of the Karen Pryor Academy. Julie received the 2006 NAVC Veterinary Technician Speaker of the Year Award and was named the 2007 Dr. Jack L. Mara Memorial Lecturer.
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Quick Course Advances in the Management of Oxidative Stress Maureen McMichael, DVM, DACVECC University of Illinois
Oxidative stress (OS) is defined as reactive oxygen species (ROS; e.g., free radicals) in excess of antioxidant defense mechanisms. Antioxidants are substances that can delay or prevent oxidation of a target molecule. OS can occur due to an excess of ROS, a reduction in antioxidants, or both. Damage due to OS has been associated with all major age-related diseases in people. OS has also been documented in several conditions in dogs1–7 and cats.8–11 OS may also play a role in joint disease.
CONDITIONS ASSOCIATED WITH OXIDATIVE STRESS Dogs • Intervertebral disk disease1 • Immune-mediated hemolytic anemia2 • Copper toxicity3 • Cancer4 • Hepatic toxicity5 • Chronic pancreatitis • Age-related cognitive dysfunction6 • Strenuous exercise7 Cats • Red blood cell and liver toxicity8 • Chronic renal failure with anemia9 • Chronic FIV infection10 • Obesity11 • Aging (geriatric cats) • Chronic metabolic diseases
Matrix metalloproteinases, which are involved in degradation of the extracellular matrix in joint cartilage, can be activated by ROS. A deficiency in extracellular superoxide dismutase (SOD), which binds to the negatively charged glycoproteins and collagen of the extracellular matrix of tissues and may be the major antioxidant in cartilage, contributes to the clinical signs associated with osteoarthritis.12 ROS are now considered an important class of carcinogen.13 The association between chronic inflammation and cancer may be mediated via the release of ROS from leukocytes during inflammation with subsequent DNA damage.13 Mice lacking or low in specific antioxidant systems show an increased rate of various cancers later in life. Some malignant cells use ROS to help themselves survive, multiply, and spread.13 Antioxidant Defense Mechanisms In health, ROS production is balanced with endogenous antioxidant defenses: • Antioxidant proteins, such as albumin, haptoglobin, ferritin, and ceruloplasmin, are abundant in plasma. • Enzymatic antioxidants, including SOD, catalase, and glutathione peroxidase, are expressed in most mammalian cells. These antioxidants prevent the generation of ROS and convert ROS into nonradical molecules. • Small-molecule antioxidants are divided into water-soluble and lipid-soluble categories. Water-soluble antioxidants include ascorbic acid (vitamin C), uric
acid, bilirubin, glutathione, zinc, and selenium. Lipid-soluble antioxidants include tocopherols (vitamin E), betacarotene, ubiquinol-10 (co-enzyme Q10), and lycopene. Cell membranes contain tocopherols and beta-carotene within their lipid layer that can act to quench chain reactions of lipid peroxidation. The extracellular fluids within the body contain numerous antioxidants, including ascorbic acid, bilirubin, transferrin, haptoglobin, albumin, urate, and ceruloplasmin. The enzymatic antioxidants tend to work synergistically and require cofactors. Superoxide is the major ROS produced during both physiologic and pathophysiologic states and is scavenged by SOD. SOD is present in the cytosol and mitochondria and on the extracellular surface. The reaction of SOD and superoxide anion creates hydrogen peroxide (H2O2), which is then detoxified by either glutathione peroxidase or catalase. Of the small-molecule antioxidants, most current research has focused on vitamins E and C and glutathione. Vitamin E inhabits the lipophilic interior of the cell membrane, where the polyunsaturated fatty acids (PUFAs) are located, and is a chain-breaking scavenger, sparing any adjacent PUFAs from oxidation. Vitamin C, the most abundant water-soluble antioxidant, can directly scavenge ROS or help scavenge ROS by regenerating vitamin E.
Sponsored by Nutramax Laboratories, Inc., maker of Oxstrin¤ Optimized Canine chewable tablets, Oxstrin Optimized Feline sprinkle capsules, and Denamarin¤ tablets for dogs and cats. For information, please call 800-925-5187 or visit nutramaxlabs.com.
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ANTIOXIDANTS: DEFENDING AGAINST OXIDATIVE STRESS The following antioxidants can be supplemented to manage oxidative stress: Glutathione is a co-substrate for the enzyme glutathione peroxidase, which detoxifies H2O2. Glutathione can also act as a metal chelator, preventing formation of the hydroxyl radical. It is synthesized in all mammalian cells; however, the liver is the primary site for glutathione synthesis, supplying up to 90% of circulating glutathione. Oxidative stress has been shown to be associated with a depletion of glutathione leading to hepatocyte death.14 Interestingly, glutathione has been shown to conjugate to carcinogens, hastening their removal, and this is thought to be an important component of endogenous detoxification.15 Cellular glutathione depletion has been implicated in the susceptibility of specific tissues (colon, rectum) to develop malignancy.14 Hepatic glutathione levels have been shown to be decreased during critical illness in people and low in cats and dogs with various hepatobiliary diseases.16,17 Managing Oxidative Stress Most successful management strategies include combining several antioxidants that act at different key sites in the OS cascade. Supplementation of antioxidants relies heavily on the bioavailability of the antioxidant for the species being targeted. Exogenous SOD has been shown to be protective in many models of ischemia– reperfusion injury. In renal transplants in humans, it has been shown to decrease acute rejection and improve 4-year graft survival.18 Vitamin E is the most important lipophilic antioxidant, and the carotenoids appear to play a crucial role in preventing OS in vivo. The products Oxstrin® Optimized Feline and Oxstrin Optimized Canine (Nutramax Laboratories, Inc.) include SOD as well as natural vitamin E and beta-carotene. They also contain certain B vitamins as well as vitamins A, D, K, and biotin. These products also have excellent safety profiles. The specific SOD complex in Oxstrin Optimized has been shown to increase circulating SOD,
• SOD • Vitamin E • SAMe
• Silybin • Beta-carotene • Zinc
catalase, and glutathione peroxidase levels in dogs and mice.19 In FIV-positive cats supplemented with Oxstrin, there was an increase in their levels of red blood cell SOD and an increase in their CD4+:CD8+ T-cell ratios.10 S-adenosylmethionine (SAMe) augments concentrations of glutathione and has been shown to be beneficial in cases of cholangiohepatitis, hepatic toxicity, and glucocorticoid-induced vacuolar hepatopathy.16,20 Silybin, the most active of the flavonolignan isomers found in silymarin,21 has been shown to have several hepatoprotective functions. One protective mechanism, prevention of fibrosis, is now being studied in relation to the prevention of pulmonary fibrosis in addition to hepatic fibrosis.22 Denamarin® (Nutramax Laboratories, Inc.) combines SAMe and silybin and has an excellent safety profile. It is likely that the types of antioxidant combination cocktails found in these products will be part of the standard of care in the treatment of many sick veterinary patients in the future. Antioxidants have the potential to benefit many organ systems during conditions of oxidative stress and therefore can help to support the overall health of veterinary patients. REFERENCES 1. McMichael MA, Ruaux CG, Baltzer WI, et al: Concentrations of 15F2t isoprostane in urine of dogs with intervertebral disk disease. Am J Vet Res 67:1226–1231, 2006. 2. Pesillo A, Freeman LM, Rush JE: Assessment of lipid peroxidation and serum vitamin E concentrations in dogs with immune-mediated hemolytic anemia. Am J Vet Res 65:1621–1624, 2004. 3. Sokol RJ, Twedt D, McKim JM Jr, et al: Oxidant injury to hepatic mitochondria in patients with Wilson’s disease and Bedlington terriers with copper toxicosis. Gastroenterology 107:1788–1798, 1994. 4. Waters DJ, Shen S, Colley DM, et al: Effects of dietary selenium supplementation on DNA damage and apoptosis in canine prostate. J Natl Cancer Inst 95:237–241, 2003.
• Selenium • Coenzyme Q10 • Vitamin C
5. Sato R, Inanami O, Syuto B, et al: The plasma superoxide scavenging activity in canine cancer and hepatic disease. J Vet Med Sci 65(4):465–469, 2003. 6. Milgram NW, Head E: Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortification: A two-year longitudinal study. Neurobiol Aging 26:77–90, 2005. 7. Hinchcliff KW, Reinhart GA, DiSilvestro R, et al: Oxidant stress in sled dogs subjected to repetitive endurance exercise. Am J Vet Res 61:512–515, 2000. 8. Center SA, Randolph JF, Warner KL, et al: The effects of S-adenosylmethionine on clinical pathology and redox potential in the red blood cell, liver and bile of clinically normal cats. J Vet Intern Med 19:303–314, 2005. 9. dos Santos MD, Lustoza MD, Mori CS, et al: Oxidative stress evaluation in cats with chronic renal failure and anemia [abstract]. Proc ACVIM:785, 2006. 10. Webb CB, Lehman TL, McCord KW: Effects of an oral superoxide dismutase enzyme supplementation on indices of oxidative stress, proviral load, and CD4:CD8 ratios in asymptomatic FIV-infected cats. J Feline Med Surg April 1, 2008 [Epub ahead of print; accessed 6/08]. 11. Tanner AE, Martin J, Saker KE: Oxidative stress and inflammatory state induced by obesity in the healthy feline. J Anim Physiol Anim Nutr 91:163–166, 2007. 12. Regan E, Flannelly J, Bowler R, et al: Extracellular superoxide dismutase and oxidant damage in osteoarthritis. Arthritis Rheum 52:3479–3491, 2005. 13. Karihtala P, Soini Y: Reactive oxygen species and antioxidant mechanisms in human tissue and their relation to malignancies. APMIS 115:81–103, 2007. 14. Kurose I, Higuchi H, Miura S, et al: Oxidative stressmediated apoptosis of hepatocytes exposed to acute ethanol intoxication. Hepatology 25:368–378, 1997. 15. Opara EC: Oxidative stress. Dis Mon 52:183–198, 2006. 16. Eaton S: The biochemical basis of antioxidant therapy in critical illness. Proc Nutr Soc 65:242–249, 2006. 17. Center SA, Warner KL, Erb HN: Liver glutathione concentrations in dogs and cats with naturally occurring liver disease. Am J Vet Res 63(8):1187– 1197, 2002. 18. Negita M, Ishii T, Kunikata S, et al: Prevention of posttransplant acute tubular necrosis in kidney graft by perioperative superoxide dismutase infusion. Transplant Proc 26:2123–2124, 1994. 19. Vouldoukis I, Conti M, Krauss P, et al: Supplementation with gliadin-combined plant superoxide dismutase extract promotes antioxidant defences and protects against oxidative stress. Phytother Res 18:957–962, 2004. 20. Polyak SJ, Morishima C, Shuhart MC, et al: Inhibition of T-cell inflammatory cytokines, hepatocytes NF-kB signaling and HCV infection by standardized silymarin. Gastroenterology 132:1925–1936, 2007. 21. Filburn CR, Kettenacker R, Griffin DW: Bioavailability of a silybin-phosphatidylcholine complex in dogs. J Vet Pharmacol Ther 30:132–138, 2007. 22. Comporti M, Signorini C, Arezzini B, et al: F2-Isoprostanes are not just markers of oxidative stress. Free Radic Biol Med 44:247–256, 2008.
This information has not been peer reviewed and does not necessarily reflect the opinions of, nor constitute or imply endorsement or recommendation by, the Publisher or Editorial Board. The Publisher is not responsible for any data, opinions, or statements provided herein.
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Canine Tick Paralysis
T
Causative Agent ICK PARALYSIS affects Lisa M. Vaughn, LVT Unlike fleas, ticks cannot jump. Instead, Francis Animal Hospital nearly all warm-blooded St. they climb on foliage and “hitch a ride” on Augusta, Ga. nearby humans or animals. As many as 64 land animals, including species of ticks have the potential to induce humans.1 When it is diagnosed in the early stages, tick paralysis in animals.5 In North America, the paralysis is easily treatable using pharmacotherapy six species typically implicated in cases of tick paralysis are Dermacentor andersoni (the Rocky (Table 1). However, in the absence of treatment, mor- Mountain wood tick), D. variabilis (the tality rates of up to 10% in humans and 7% in domes- American dog tick), Amblyomma americanum (the lone star tick), A. maculatum (the Gulf tic animals have been reported.1 Coast tick), Ixodes scapularis (the black-legged Unlike tick-borne diseases that are caused by infection with a pathogen, such as Lyme disease and Rocky Mountain spotted fever, tick paralysis is caused by transmission of a neurotoxin secreted by the salivary glands of gravid (egg-laden) female ticks during feeding.2,3 The neurotoxin responsible for tick paralysis was first isolated in 19664; it causes a form of motor paralysis similar to that associated with Guillain-Barré syndrome in humans.3
tick), and I. pacificus (the western black-legged tick).3 It is thought that gravid females are responsible for neurotoxin transmission because they feed for a longer period and inject greater amounts of neurotoxin into the host than do males and nongravid females.6
Pathogenesis Tick paralysis primarily affects a dog’s motor pathways, although its autonomic and sensory pathways also may be compromised.5 The neurotoxin depolarizes the acetylcholine
Table 1. Tick Control Products for Dogsa Product (Manufacturer)
Active Ingredient(s)
Minimum Route of Frequency b Age Administration
Frontline Plus for Dogs (Merial) Frontline Spray (Merial) Frontline Top Spot for Dogs (Merial) K9 Advantix (Bayer Animal Health) ProMeris for Dogs (Fort Dodge Animal Health) Proticall (Intervet/Schering-Plough Animal Health) Revolutionc (Pfizer Animal Health) Vectra 3D (Summit VetPharm) Virbac Long-Acting KnockOut Spray (Virbac Animal Health) Virbac Pyrethrin Dip (Virbac Animal Health)
Fipronil, (S)-methoprene Fipronil Fipronil Imidacloprid, permethrin Metaflumizone, amitraz Permethrin Selamectin Dinotefuran, permethrin, pyriproxyfen Permethrin, pyriproxyfen
8 weeks 8 weeks 8 weeks 7 weeks 8 weeks 4 weeks 6 weeks 7 weeks 12 weeks
Topical Spray Topical Topical Topical Topical Topical Topical Spray
Monthly Monthly Monthly Monthly Monthly Monthly Monthly Monthly Monthly
Pyrethrins, piperonyl butoxide, N-octyl bicycloheptene dicarboximide, di-N-propyl isocinchomeronate
12 weeks
Dip
No more than once every 7 days
a
These products also are approved for control of other parasites. See the product label for information on the exact dosing frequency. c Approved for control of Dermacentor variabilis infestation. b
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Glossary Atelectasis_Total or partial lung collapse Crepitation_Crackling or grating sound or sensation Cyanosis_Bluish discoloration of the skin and mucous membranes resulting from deficient oxygenation of the blood release mechanism in the presynaptic nerve terminals, causing a reduction in secretion.7 Because of the reduction in bioavailable acetylcholine, the animal develops flaccid paralysis (loss of muscle control). Respiratory failure may occur because of pulmonary edema, respiratory muscle paralysis, or aspiration of esophageal or gastric contents. Affected dogs usually experience paralysis of the esophageal muscles and may develop megaesophagus (esophageal dilation). Saliva and ingested food or fluid then collect in the esophagus and are regurgitated into the pharynx and mouth. Because of the loss of the gag reflex, the animal cannot clear this material from its airway, potentially causing aspiration pneumonia.5 Death usually results from respiratory failure caused by paralysis of the diaphragm, intercostal muscles, and muscles in the upper and lower airways.4 www.VetTechJournal.com
Clinical Signs On average, clinical signs of tick paralysis begin to appear 6 to 9 days after tick attachment, but a range of 3 to 10 days has been reported.7 Patients may present with mild signs of hindlimb incoordination and paresis. However, as the disease progresses, they may begin to experience dyspnea, vomiting, facial weakness, loss of reflexes, and an inability to stand.7 Respiration initially may be tachypneic and forced, but as the neurotoxin moves through the body, respiration can become bradypneic or labored, especially on expiration. In the later stages of the disease, the patient may become cyanotic, a characteristic sign of severe hypoxemia.8 As the paralysis ascends, the animal may be unable to sit, move its limbs, or lift its head.5 When the toxin progresses cranially, muscles in the pharynx, larynx, esophagus, and trachea begin to weaken, resulting in gagging, vomit-
Decubitus_Pressure-induced skin ulceration that can occur following a period of immobility; also called bed sore Hypercapnia_Increased concentration of carbon dioxide in the blood; also called hypercarbia Hypoventilation_Abnormally slow and shallow respiration resulting in an increased level of carbon dioxide in the blood Hypoxemia_Insufficient oxygenation of arterial blood Hypoxia_Deficiency in the amount of oxygen reaching the body tissues Neurotoxin_Chemical substance that attacks the nervous system
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CE Article #1 Canine Tick Paralysis
Dermacentor variabilis
Amblyomma americanum
(the American dog tick)
(the lone star tick)
Source: CDC/James Gathany
Source: CDC/James Gathany
Mat Pound, USDA Agricultural Research Service, Bugwood.org
Dermacentor andersoni (the Rocky Mountain wood tick)
Amblyomma maculatum
Ixodes scapularis
Ixodes pacificus
(the Gulf Coast tick)
(the black-legged tick)
(the western black-legged tick)
ing, drooling, and coughing.7 Megaesophagus and decreased gag reflex may contribute to respiratory distress as a result of the pooling of saliva and the inability to swallow.7 The patient also may experience facial paralysis.7 The patient’s temperature is usually within the normal range in the early stages of the disease.5 However, animals with low body mass may develop hypothermia, which can increase as a result of stress.5 Conversely, affected animals can develop hyperthermia because of a reduced ability to pant.9 Unlike tick-borne diseases involving transmission of pathogens, which can proliferate and continue to cause clinical signs in the infected animal after the tick has been removed, tick paralysis occurs only while the tick is attached and transmitting the neurotoxin into the animal’s bloodstream. Therefore, the patient’s clin474
Source: CDC/James Gathany
Source: CDC/James Gathany
Mat Pound, USDA Agricultural Research Service, Bugwood.org
Ticks That Cause Paralysis Six tick species are typically implicated in cases of tick paralysis in North America.3
AUGUST 2008 | Veterinary Technician
ical signs usually resolve within 1 to 3 days after the tick has been removed.5 If the animal does not receive treatment, progressive pulmonary dysfunction can occur, leading to hypoxia, hypercapnia, respiratory acidosis, and death.5
Prevalence Cases of tick paralysis have been reported worldwide but are expected to occur more frequently in tick-endemic areas. Tick paralysis is most prevalent in the northwestern and southeastern regions of North America, as well as the eastern coast of Australia and southern Africa.1 In North America, the greatest number of human cases of tick paralysis occur during April, May, and June when Dermacentor spp are most actively seeking hosts.10 In such regions as the southern United States, tick activity can occur throughwww.VetTechJournal.com
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out the year, increasing the potential for human and animal cases of tick paralysis and other tick-borne diseases. Although tick paralysis is relatively rare, it is among the top eight most common tick-borne diseases reported in humans in the United States.11
Diagnosis When a patient presents with clinical signs of tick paralysis, the veterinary technician should obtain a thorough history. On physical examination, a large, bloodengorged female tick may be found, usually around the patientâ&#x20AC;&#x2122;s head or neck, in the ear canals, around the genital area, or between the toes.6,12 No specific tests are available for diagnosing canine tick paralysis. Electroencephalography, complete blood cell count, serum chemistry profile, and urinalysis usually yield normal results.5,7 However, lateral thoracic radiography may show the presence and degree of disease-associated complications, such as pulmonary edema and megaesophagus.5 Arterial blood gas analysis may reveal hypoxemia, hypercapnia, and low pH7; in severely affected patients, arterial carbon dioxide pressure values may exceed 60 mm Hg (normal: 35â&#x20AC;&#x201C;45), indicating the presence of respiratory acidosis.8 In patients with pulmonary edema, crepitation, which indicates the presence of fluid in the airway, may be heard on auscultation.8 Diagnostic differentials include botulism, snakebite, coonhound paralysis, distal denervating disease, acute peripheral neuropathy, and generalized multifocal myelopathy.5 In regions where ticks are endemic, tick paralysis should be considered when a patient presents with leg weakness, megaesophagus, unexplained vomiting, or acute left-sided congestive heart failure.5
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Treatment Tick removal is the most important element of treatment. Because the animal will continue to exhibit clinical signs until the tick is removed, thorough examination of the patient by the veterinarian is essential. Clipping long or matted hair is recommended, and using acaricidal dips helps ensure that all ticks are killed. However, the stress associated with clipping and bathing may increase hypothermia, especially in fractious or nervous patients.5 Therefore, the veterinarian may prescribe a sedative and give the patient time to calm down before he or she performs these procedures.5 Severely affected animals may require hospitalization. Patients with respiratory acidosis should receive oxygen supplementation as supportive care, and patients with bradypneic, arrhythmic, or weak breathing patterns should be intubated and ventilated to correct hypoventilation.8 Mechanical or manual ventilation also may be required.5 The veterinarian may administer
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CE Article #1 Canine Tick Paralysis propofol as a constant-rate infusion in patients requiring endotracheal intubation and ventilator support.9 During the first 48 hours of hospitalization, intravenous fluids typically are not required and may actually contribute to or worsen pulmonary edema.5 However, the patient should be evaluated periodically for signs of dehydration.9 If intravenous fluids are warranted, they should be administered at maintenance or submaintenance levels.5 If the patient’s packed cell volume is greater than 50%, colloids (e.g., hetastarch, pentastarch) administered slowly at submaintenance levels are recommended over crystalloids (e.g., Normosol-R, normal saline solution), as the latter can exacerbate pulmonary edema.5 The veterinarian will avoid medication that interferes with neuromuscular transmission, such as tetracyclines, aminoglycosides, or procaine penicillin.10 Furosemide can be given intravenously to reduce pulmonary edema.5 Food and water should be withheld until paralysis resolves.13 The patient should be placed in sternal recumbency to facilitate respiration and reduce hypostatic congestion.9 If the patient must lie in lateral recumbency, it should be rotated at least every 4 hours to prevent hypostatic pneumonia.9 In addition, patients that are left immobile and in positional stasis for long periods are at risk for developing tissue necrosis and decubiti over
Tips for Tick Removal 3,a 1. Using tweezers or forceps, grasp the tick as close to the pet’s skin as possible.
2. Remove the tick using slow, steady pressure. 3. Do not crush or twist the tick or yank it from the pet’s skin because the tick’s mouthparts may become detached and remain in the skin, potentially causing injury or infection. 4. Do not use a lit match or other products, such as petroleum jelly or nail polish, to remove the tick. US Army Center for Health Promotion and Preventive Medicine. Tick Removal. Accessed July 2008 at chppmwww.apgea.army.mil/ento/TickEduc/Tickremoval.pdf.
a
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bony protuberances.8 Regional edema also may be associated with positional stasis because drainage of the lymphatic system is impeded. Accumulation of secretions and atelectasis in the lower regions of the lung may occur, along with contractures and stiffening of muscles and ligaments.8 Depending on the individual patient’s needs, a variety of supportive therapies may be indicated, including the following: Application of eye protectants, such as ocular lubricants or artificial tears, to prevent eye dryness5 Catheterization or manual bladder expression if the patient is unable to empty its bladder9 Suctioning of the pharynx, larynx, and proximal esophagus to minimize respiratory distress associated with esophageal dysfunction and the pooling of saliva5 (in animals with severe dyspnea, general anesthesia may be needed to allow oxygen administration, esophageal suction, and pulmonary drainage)5
Prevention The technician should educate clients about the importance of preventing tick paralysis and other tick-borne diseases, especially in endemic areas. Owners should know the proper way to remove ticks from their pet (see box to the left). Regularly examining the pet’s haircoat for ticks is essential. Clients should be instructed on the proper use of veterinarian-prescribed acaricides (Table 1) to help prevent their pet from becoming infested. Clients also should be told about environmental controls, including keeping grass cut short and trimming bushes. To help control ticks, acaricides can be sprayed in the yard and along fences. It is important that these products be used according to the instructions on the label. Acaricides for use indoors also are available, but application by a licensed exterminator is recommended.3 These products should be allowed to dry before animals or humans return to the area.3
Role of the Technician When a dog presents to the veterinary clinic with clinical signs of tick paralysis, the technician is responsible for obtaining an accurate and complete patient history, noting clinical signs and progression of paralysis, collecting www.VetTechJournal.com
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specimens for analysis, and providing supportive care. The technician can play a major role in reducing the incidence of this disease by educating clients about environmental controls and preventive measures that will help the pet — and the owner — remain tick-free.
References
1. Powell C. WSU Veterinary College Warns Llama and Alpaca Owners of Tick Paralysis. Accessed July 2008 at www.wsunews.wsu.edu/ pages/publications.asp?Action=Detail&PublicationID=11136. 2. US Army Center for Health Promotion and Preventive Medicine, Entomological Sciences Program. Tick Paralysis. Accessed July 2008 at chppm-www.apgea.army.mil/ento/facts/TickParalysisJusttheFactsJan05.pdf.
3. Companion Animal Parasite Council. Ectoparasites: Ticks Guidelines. Accessed July 2008 at www.capcvet.org/?p=Guidelines_Ticks& h=0&s=0. 4. Doube BM. Cattle and the paralysis tick Ixodes holocyclus. Aust Vet J 1975;51(11):511-515. 5. Tick paralysis. In: Kahn CM, ed. The Merck Veterinary Manual. 9th ed. Whitehouse Station, N.J.: Merck & Company; 2005:1073-1076.
Are you ready to offer your clients a home delivery service, without managing inventory or shipping a thing?
6. Samuels MA. Manual of Neurologic Therapeutics. Philadelphia: Lippincott Williams & Wilkins; 2004:272-273. 7. Cuddon P. Tick bite paralysis. In: Tilley LP, Smith FWK, eds. The 5-Minute Veterinary Consult: Canine and Feline. Baltimore: Williams & Wilkins; 1997:1104-1105. 8. Mellema M, Haskins S. Supportive care of the poisoned patient. In: Peterson ME, Talcott PA, eds. Small Animal Toxicology. 2nd ed. St. Louis: Elsevier Saunders; 2006:73-75, 96-97, 121-122. 9. Fischer N. Tick Poisoning in Animals — In Depth. Accessed July 2008 at www.tickalert.org.au/paraldet.htm.
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10. Dworkin MS, Shoemaker PC, Anderson DE. Tick paralysis: 33 human cases in Washington State, 1946–1996. Clin Infect Dis 1999;29(6):1435-1439. 11. Spach DH, Liles WC, Campbell GL, et al. Tick-borne diseases in the United States. N Engl J Med 1993;329(13):936–947. 12. Wright RE, Barker RW. Common Ticks of Oklahoma and Tick-Borne Diseases. Accessed July 2008 at www.okrangelandswest.okstate. edu/pdfFiles/OSUextPubs/F-7001.pdf.
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13. Braund KG. Clinical Syndromes in Veterinary Neurology. St. Louis: Mosby; 1994:273-274. (text continues on page 483)
ABOUT THE AUTHOR
Lisa M. Vaughn, LVT Lisa is a veterinary technician at St. Francis Animal Hospital in Augusta, Ga. In addition to her full-time job, Lisa is working toward a bachelor’s degree in biology at Augusta State University and hopes to enter veterinary school.
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EquineEssentials
Arterial Blood Pressure Monitoring Deborah B. Reeder, RVT San Diego, Calif.
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EASURING ARTERIAL BLOOD PRESSURE, which has been an integral part of human medicine for many years, can be critical to the outcome of equine patients. During physical examination, the cardiovascular status of a patient typically is evaluated by checking its oral mucous membranes, heart rate, and pulse. In some patients, it also would be informative to measure the blood pressure, especially in horses undergoing general anesthesia and in critically ill patients, including critically ill neonatal foals, patients in septic shock, or patients with colic, laminitis, or epistaxis.1 (See the box below.) Other conditions that may require arterial blood pressure monitoring include acute hemorrhage, colitis, cardiac failure, and anaphylactic reactions. Understanding the Blood Pressure Components Arterial blood pressure, which is the product of cardiac output, blood volume, and blood vessel resistance, is the force with which blood flows through the arteries to the periphery of the body. These thick-walled muscular vessels transport blood under high pressure to deliver such vital components as oxygen and nutrients to peripheral tissues and organs. Three parameters are used to assess arterial blood pressure: systolic, diastolic, and mean arterial pressures. The systolic pressure is the maximum pressure generated by the left ventricle during contraction, and diastolic pressure
Why Arterial Blood Pressure Monitoring Is Important Allows better assessment of the patient’s condition Provides the ability to monitor the patient’s response to therapy Provides a database to assist in patient care Determines the effect of anesthesia on the patient’s cardiovascular system Allows educated assumptions relating to cardiac performance, myocardial oxygen consumption, vascular tone, and organ and tissue perfusion
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is the minimum pressure achieved during relaxation. Mean arterial pressure (MAP) is the major determinant of perfusion pressure to most organs of the body and should be closely monitored during anesthesia.1 Horses need to maintain blood pressure within a range that is adequate for blood delivery, called perfusion, to peripheral tissues, ensuring adequate delivery of oxygen and nutrients and removal of metabolic waste products. Under normal conditions, horses maintain constant arterial blood pressure to perfuse their whole body. However, in certain disease states and when undergoing general anesthesia, levels often are altered.2 The MAP required to perfuse organs and tissues is approximately 60 mm Hg. In adult horses, normal systolic pressure is 110 to 160 mm Hg and normal diastolic pressure is 90 to 110 mm Hg, creating a MAP of 110 to 120 mm Hg. Under anesthesia, the MAP in a horse should remain above 60 mm Hg. Normal values for neonatal foals (<1 month old) are much lower than those for adult horses and vary by patient, depending on age and cardiovascular status. It is not uncommon for a neonatal foal to have a systolic pressure of 80 to 100 mm Hg, diastolic pressure of 40 to 60 mm Hg, and MAP of 50 to 60 mm Hg. www.VetTechJournal.com
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Blood Pressure Measurement: Indirect Method
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Step 1. Select the correctly sized blood pressure cuff, such as an adult cuff for an adult patient.
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Courtesy of Mid-Atlantic Equine Medical Center; A. G. Photography
Step 2. Wrap the cuff around the foal’s or adult horse’s tail, making sure that it is centered over the coccygeal artery.
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Step 3. Monitor the blood pressure readings. Veterinary Technician | AUGUST 2008
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Blood Pressure Measurement: Direct Method
Step 2. After putting on sterile gloves and removing the catheter from the package, insert the catheter into the transverse facial artery until you see bright-red blood in the hub of the catheter. Courtesy of Mid-Atlantic Equine Medical Center; A. G. Photography
Step 1. Clip and sterile prep the area over the artery. Inset: Catheters and extension set for arterial catheter placement.
Step 3. Attach the extension set to the catheter and tape it in place.
Step 4. Monitor the blood pressure readings.
Physiologic factors that can affect the MAP include ventricular failure, myocardial depression (as occurs with anesthesia), hypovolemia, positive-pressure ventilation, and the presence of endotoxins. Changes in blood pressure include hypertension (high blood pressure) and hypotension (low blood pressure). Hypertension is not common in horses, but hypotension can develop when a horse is undergoing general anesthesia and in certain disease states, such as colitis, septic shock, or hemorrhagic shock. Hypotension also can result from decreased 480
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fluid volume in the blood vessels, decreased blood vessel tone, or â&#x20AC;&#x153;leakyâ&#x20AC;? blood vessels. If the patient develops hypotension (MAP <60 mm Hg), there will be less blood volume delivered to peripheral tissues and decreasing oxygen and nutrient delivery. The average arterial pressure level at which blood ceases to flow is about 20 mm Hg.2
Blood Pressure Measurement There are two methods of assessing blood pressure in horses: direct and indirect. The indirect method of monitoring arterial blood www.VetTechJournal.com
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It’s time to really connect with your clients and realize greater profit for your practice. Vetstreet’s automatic email services build client compliance.
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EquineEssentials Some Precautions to Address When monitoring blood pressure in equine patients, the following information should be considered: The cuff must be the correct size and placed properly over the artery to obtain accurate blood pressure readings using the indirect method. An arterial pulse can be used to count beats of the pulse and compare with the heart rate to help detect pulse deficits. You cannot directly measure blood pressure by palpating the pulse in a peripheral artery. If you have difficulty catheterizing an artery, it may indicate low blood pressure (hypotension — most commonly the result of hypovolemia). If both the systolic and diastolic pressures are low, the animal is most likely hypotensive. Alterations in blood pressure are a good index of depth of anesthesia — blood pressure falls as the depth of anesthesia deepens. pressure is noninvasive and more commonly used in neonatal foals or adult horses that are not anesthetized. This method is not as accurate as the direct method and provides a trend rather than an absolute determination of the blood pressure level. The indirect method (shown on page 479) can be done in one of two ways.2,3 The first involves an oscillometric monitor and placement of an air-filled cuff around a peripheral limb or at the base of the tail. Accuracy depends on using the correctly sized cuff as well as correctly placing the cuff over the artery. This type of indirect method can be inaccurate when the heart rate is slower than 25 beats/min and the blood pressure is low — less than 60 mm Hg. It also is less accurate in standing adult horses. The second way to measure indirect blood pressure involves the use of an ultrasonic Doppler apparatus (not shown here), which consists of a Doppler crystal and an aneroid gauge within a cuff that is placed over a periph-
ABOUT THE AUTHOR
Deborah B. Reeder, RVT
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eral artery.2,4–6 The cuff is inflated until a pulse is heard, which measures the systolic blood pressure on the gauge. This can be accurate to a blood pressure reading of 40 mm Hg.7 Direct measurement is more accurate and is considered the gold standard. It is advantageous when monitoring patients that are undergoing general anesthesia or critically ill patients but requires catheterization of an artery. The direct method (shown on page 480) is invasive and requires catheterization of a peripheral artery but is more accurate and provides a continuous reading.2,4 However, there is risk for potential complications, including infection and hematomas. With this method, a 17- to 21-gauge catheter is placed into a metatarsal, metacarpal, facial, or transverse facial artery and is connected to a monitor or an aneroid manometer through extension sets and a three-way stopcock. When using a manometer, a pressure bag or syringe of heparinized saline is used to flush the lines, open the arterial line to the manometer, and
Deborah is most known for her involvement in forming the American Association of Equine Veterinary Technicians, and she continues to serve as executive director. For the past 7 years, she has done consulting work for equine practices and the industry. In addition, Deborah is a member of the Association of Veterinary Practice Managers and Consultants, Texas Association of Registered Veterinary Technicians, Texas Veterinary Medical Association (Hon), and United States Equestrian Foundation.
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create pressurization so that the mean pressure is read between the bounce of the needle. Regardless of which method you use, there are precautions that should be addressed (see box on page 482).
Role of the Technician Monitoring arterial blood pressure in the equine patient is an important tool in your role in the overall assessment of a patientâ&#x20AC;&#x2122;s condition. Alterations in arterial blood pressure can provide a warning of an abrupt change in the patientâ&#x20AC;&#x2122;s condition. It is a useful tool to monitor critically ill equine patients, especially critically ill neonatal foals and horses undergoing general anesthesia. Because they cannot verbally tell us what is going on, measuring blood pressure aids our understanding of their condition and provides an invaluable tool in monitoring their response to treatment.
References
1. Gay CC, McCarthy J, McCarthy M, et al. The value of arterial blood pressure measurement in assessing the prognosis in equine colic. Equine Vet J 1977;9:202-204.
2. Smarick S. Direct and indirect blood pressure: indications and methods. Proc Int Vet Emerg Crit Care Symp:2007. 3. Rose RJ, Rossdale PD. Techniques and clinical applications of arterial blood collection in the horse. Equine Vet J 1981;13:70-73. 4. Giguere S, Knowles HA Jr, Valverde A, et al. Accuracy of indirect measurement of blood pressure in neonatal foals. J Vet Intern Med 2005;19(4):571-576. 5. Gay CC, McCarthy J, McCarthy M, et al. A method for indirect measurement of arterial blood pressure in the horse. Aust Vet J 1977;53:163-166. 6. Latshaw H, Fessler JF, Whistler SJ, Geddes LA. Indirect blood pressure measurement of mean blood pressure in the normotensive and hypotensive horse. Equine Vet J 1979;11:191194. 7. Nout YS, Corley KT, Donaldson LL, Furr MO. Indirect oscillometric and direct blood pressure measurements in anesthetized and conscious neonatal foals. J Vet Emerg Crit Care 2002;12(2):75-80.
CE Article #1 Canine Tick Paralysis
(continued from page 477)
Article #1 CE Test The article you have read qualifies for 0.5 credit hour. To receive credit from Alfred State College, choose the best answer to each of the following questions. Either fax (800-589-0036) your answers or participate online.
1. ________ is a clinical sign characteristic of patients presenting with tick paralysis. a. Inappetence b. Diarrhea c. Hindlimb incoordination d. Pneumothorax 2. High arterial carbon dioxide pressure levels are associated with a. pulmonary edema. b. respiratory alkalosis. c. metabolic acidosis. d. respiratory acidosis. 3. Mortality rates of up to ________ have been reported in domestic animals when the neurotoxin-transmitting tick is not removed. a. 5% b. 7% c. 10% d. 15% www.VetTechJournal.com
Take this CE test for FREE! Go to www.VetTechJournal.com.
4. Which of the following practices is recommended during tick removal? a. Applying petroleum jelly to the tick b. Grasping the tick with tweezers or forceps c. Yanking the tick off the skin d. Using a match to make the tick back up 5. In the later stages of tick paralysis, the patient may become cyanotic, a characteristic sign of severe a. hyperthermia. b. respiratory acidosis. c. hypoxemia. d. edema. 6. Tick paralysis is caused by transmission of a. a salivary neurotoxin. b. an allergen. c. a bacterium. d. a cyanotoxin. 7. The most important aspect of tick paralysis treatment is
a. b. c. d.
administering IV Normosol-R. removing the tick. applying acaricides. bathing the patient.
8. After tick attachment, clinical signs of tick paralysis usually begin within a. 1 to 3 hours. b. 6 to 9 days. c. 1 to 2 weeks. d. 6 to 9 months. 9. In animals with tick paralysis, ________ secretion is reduced. a. norepinephrine b. dopamine c. acetylcholine d. serotonin 10. Drugs that are contraindicated for use in patients with tick paralysis include a. tetracyclines. b. aminoglycosides. c. procaine penicillin. d. all of the above Veterinary Technician | AUGUST 2008
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Q
Deborah (Puppel) Martin, BS, RVT, CPDT Debbie, an animal behavior technician, has a BS in human ecology from The Ohio State University and an AAS in veterinary technology from Columbus State Community College. She has been a full-time registered veterinary technician since 1996 and has been involved in the field of animal behavior. Debbie is an active member and the previous recording secretary of the Society of Veterinary Behavior Technicians (SVBT). She is a member of the Association of Pet Dog Trainers (APDT) and was the first Certified Professional Dog Trainer in Louisiana.
Ask the
TECHspert
What causes psychogenic grooming, and how can a cat be discouraged from exhibiting this behavior?
Amanda Daum, RVT Edmond, Okla.
Rule-Out Diagnostic Testing Urinalysis Fecal analysis Complete blood count Chemistry profile Thyroid and endocrine tests Fungal culture and skin scrape Skin biopsy (if lesions are present) Trichogram (microscopic evaluation of the hair) 484
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xcessive grooming associated with a psychological cause is the predominant clinical sign of feline psychogenic alopecia, a well-recognized, noninflammatory skin disorder that is sometimes referred to as psychogenic grooming. Psychogenic alopecia can be a consequence of: A behavior disorder, such as displacement behavior, brought on by environmental stressors or anxiety1 A behavior originally caused or exacerbated by a medical condition but has continued since the condition was resolved Asian breeds, including the Siamese, are predisposed to the disorder.2
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Diagnostic Differentials Because self-induced alopecia is often the result of a medical disorder, a diagnosis of psychogenic alopecia requires the veterinarian to exclude unresolved dermatologic, metabolic, or other medical conditions, including allergies, cystitis, fungal infections, parasite infestation, orthopedic pain, and any metabolic disease that affects the skin or hair coat, such as kidney, liver, or thyroid disease.3 Many cats presumed to have psychogenic alopecia actually have atopy.4 However, there may be a link between the two conditions because stress has been shown to increase epidermal permeability in humans.5 Consequently, stress may predispose cats to atopy. To rule out medical causes, the veterinarian will order a complete health and behavior history should be detailed and appropriate tests conducted (see box at the left).4 Parasite treatment and a food elimination trial
also should be recommended. Even after a medical problem has been resolved, the unacceptable behavior may continue.6 For example, a cat with flea allergy dermatitis secondary to severe flea infestation might groom excessively. But if the cat continues to groom excessively after the flea infestation has been resolved, other factors must be considered. Physical examination findings can be useful in making a diagnosis. Cats with psychogenic alopecia generally have: Hair loss only in areas they can reach when grooming Short, broken hairs Substantial amounts of hair in the feces A history of hairballs Because reclusive grooming is common in cats, clients may or may not have observed the behavior. After medical factors have been ruled out and the alopecia has been determined to be behavioral, the reason for the behavior should be determined. Diagnostic differentials for feline psychogenic alopecia include acute conflict behavior, attention-seeking behavior, compulsive disorder, separation anxiety, and displacement behavior from chronic environmental stress.
Behavior Modification Treatment can vary according to the behavior diagnosis, and medication may be appropriate in some cases. After a veterinarian has made a diagnosis and prescribed a behavioral treatment plan, the veterinary technician can explain behavior and environmental modification to the client. Be consistent: Inconsistency and un(text continues on page 487)
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PREVICOX® (firocoxib)
HAPPY DOGS. HAPPY CLIENTS. TM
Imagine how you’d feel if you were the owner of a dog with OA. The helper that trampled your flower beds and dug up your borders – in short, made gardening worthwhile – can’t even come out to play. Your client might think it’s old age, but if it’s osteoarthritis, PREVICOX and you can make a difference in both their lives. Give your clients the change they’re looking for, and your patients the relief they need. Dispense PREVICOX.
GREAT NEWS!
NOW APPROVED FOR USE IN CONTROLLING POSTOPERATIVE PAIN AND INFLAMMATION ASSOCIATED WITH SOFT-TISSUE SURGERY IN DOGS.
In one survey for osteoarthritis, 97% of owners were satisfied with PREVICOX.2
As a class, cyclooxygenase inhibitory NSAIDs may be associated with gastrointestinal, kidney or liver side effects. These are usually mild, but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including PREVICOX. Use with other NSAIDs, corticosteroids or nephrotoxic medication should be avoided. Refer to the prescribing information for complete details or visit www.previcox.com. 1
Ryan WG, Moldave K, Carithers D. Clinical effectiveness and safety of a new NSAID, firocoxib: a 1,000-dog study. Vet Ther 2006;7(2):119-126. 2 Data on file at Merial. SEE PRESCRIBING INFORMATION ON PAGE 486.
®PREVICOX is a registered trademark, and ”HAPPY DOGS. HAPPY CLIENTS.” is a trademark, of Merial. ©2008 Merial Limited, Duluth, GA. All rights reserved. PVX08CNPORCHSGLAD.
TM
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CHEWABLE TABLETS For oral use in dogs only. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. DESCRIPTION: PREVICOX® (firocoxib) belongs to the coxib class of non-narcotic, non-steroidal anti-inflammatory drugs. Firocoxib is a white crystalline compound described chemically as 3-(cyclopropylmethoxy)-4-(4-(methylsulfonyl) phenyl)-5, 5-dimethylfuranone. The empirical formula is C17H20O5S, and the molecular weight is 336.4. The structural formula is shown below:
PHARMACOKINETICS: The absolute bioavailability of PREVICOX (firocoxib) is approximately 38% when administered as a 5 mg/kg oral dose to fasted adult dogs. Firocoxib is rapidly cleared from the blood via hepatic metabolism and fecal excretion (CLsystemic = ~0.4 L/hr/kg). Despite a high level of plasma-protein binding (96%), firocoxib exhibits a large volume of distribution (Vdλof total drug = ~4.6 L/kg) and a terminal elimination half-life of 7.8 hours (%CV = 30%). The oral drug absorption process is highly variable among subjects. Co-administration of PREVICOX with food delays drug absorption (Tmax from 1 to 5 hours) and decreases peak concentrations (Cmax from 1.3 to 0.9 mcg/mL). However, food does not affect the overall oral bioavailability at the recommended dose. INDICATIONS: PREVICOX (firocoxib) Chewable Tablets are indicated for the control of pain and inflammation associated with osteoarthritis and for the control of postoperative pain and inflammation associated with soft-tissue surgery in dogs. DOSAGE AND ADMINISTRATION: Always provide the Client Information Sheet with prescription. Carefully consider the potential benefits and risks of PREVICOX and other treatment options before deciding to use PREVICOX. Use the lowest effective dose for the shortest duration consistent with individual response. The recommended dosage of PREVICOX (firocoxib) for oral administration in dogs is 2.27mg/lb (5 mg/kg) body weight once daily as needed for osteoarthritis and for 3 days as needed for postoperative pain and inflammation associated with soft-tissue surgery. The dogs can be treated with PREVICOX approximately two hours prior to surgery. The tablets are scored and dosage should be calculated in half-tablet increments. PREVICOX Chewable Tablets can be administered with or without food. CONTRAINDICATIONS: Dogs with known hypersensitivity to firocoxib should not receive PREVICOX. WARNINGS: Not for use in humans. Keep this and all medications out of the reach of children. Consult a physician in case of accidental ingestion by humans. For oral use in dogs only. Use of this product at doses above the recommended 2.27 mg/lb (5.0 mg/kg) in puppies less than seven months of age has been associated with serious adverse reactions, including death (see Animal Safety). Due to tablet sizes and scoring, dogs weighing less than 12.5 lb (5.7 kg) cannot be accurately dosed. All dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy. Appropriate laboratory testing to establish hematological and serum baseline data is recommended prior to and periodically during administration of any NSAID. Owners should be advised to observe for signs of potential drug toxicity (see Adverse Reactions and Animal Safety) and be given a Client Information Sheet about PREVICOX Chewable Tablets. For technical assistance or to report suspected adverse events, call 1-877-217-3543. PRECAUTIONS: This product cannot be accurately dosed in dogs less than 12.5 pounds in body weight. Consider appropriate wash-out times when switching from one NSAID to another or when switching from corticosteroid use to NSAID use. As a class, cyclooxygenase-inhibitory NSAIDs may be associated with renal, gastrointestinal and hepatic toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest risk for adverse events are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached and monitored. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Since NSAIDs possess the potential to produce gastrointestinal ulcerations and/or gastrointestinal perforations, concomitant use with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. The concomitant use of protein-bound drugs with PREVICOX Chewable Tablets has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant, and behavioral medications. The influence of concomitant drugs that may inhibit the metabolism of PREVICOX Chewable Tablets has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy. If additional pain medication is needed after the daily dose of PREVICOX, a non-NSAID class of analgesic may be necessary. Appropriate monitoring procedures should be employed during all surgical procedures. Anesthetic drugs may affect renal perfusion, approach concomitant use of anesthetics and NSAIDs cautiously. The use of parenteral fluids during surgery should be considered to decrease potential renal complications when using NSAIDs perioperatively. The safe use of PREVICOX Chewable Tablets in pregnant, lactating or breeding dogs has not been evaluated. ADVERSE REACTIONS : OSTEOARTHRITIS : In controlled field studies, 128 dogs (ages 11 months to 15 years) were evaluated for safety when given PREVICOX Chewable Tablets at a dose of 2.27 mg/lb (5.0 mg/kg) orally once daily for 30 days. The following adverse reactions were observed. Dogs may have experienced more than one of the observed adverse reactions during the study.
Adverse Reactions Seen in U. S. Field Studies Adverse Reactions Vomiting Diarrhea Decreased Appetite or Anorexia Lethargy Pain Somnolence Hyperactivity
PREVICOX n=128 5 1 3 1 2 1 1
Active Control n=121 8 10 3 3 1 1 0
PREVICOX (firocoxib) Chewable Tablets were safely used during field studies concomitantly with other therapies, including vaccines, anthelmintics, and antibiotics. SOFT-TISSUE SURGERY: In controlled field studies evaluating soft-tissue postoperative pain and inflammation, 258 dogs (ages 10.5 weeks to 16 years) were evaluated for safety when given PREVICOX Chewable Tablets at a dose of 2.27 mg/lb (5.0 mg/kg) orally approximately 2 hours prior to surgery and once daily thereafter for up to two days. The following adverse reactions were observed. Dogs may have experienced more than one of the observed reactions during the study.
Adverse Reactions Seen in the Soft-tissue Surgery Postoperative Pain Field Study. Adverse Reactions Vomiting Diarrhea Bruising at Surgery Site Respiratory Arrest SQ Crepitus in Rear Leg and Flank Swollen Paw
Firocoxib Group (n=127) 5 (3.94%) 1 (0.79%) 1 (0.79%) 1 (0.79%) 1 (0.79%) 1 (0.79%)
Control Group* (n=131) 6 (4.58%) 1 (0.76%) 1 (0.76%) 0 (0.0%) 0 (0.0%) 0 (0.0%)
Gastrointestinal: Vomiting, anorexia, diarrhea, melena, hematemesis, hematochezia, weight loss, nausea, gastrointestinal ulceration, gastrointestinal perforation, salivation. Urinary: Azotemia, elevated creatinine, polydipsia, polyuria, urinary tract infection, hematuria, urinary incontinence, renal failure. Hematological: Anemia, thrombocytopenia. Hepatic: Hepatic enzyme elevations, decreased or increased total protein and globulin, decreased albumin, decreased BUN, icterus, ascites, pancreatitis. Neurological / Behavioral / Special Sense: Lethargy, weakness, seizure, ataxia, aggression, tremor, uveitis, mydriasis, nystagmus. Cardiovascular / Respiratory: Tachypnea. Dermatological / Immunological: Fever, facial / muzzle edema, pruritis, urticaria, moist dermatitis. In rare situations, death has been reported as an outcome of the adverse events listed above. INFORMATION FOR DOG OWNERS: PREVICOX, like other drugs of its class, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with drug intolerance. Adverse reactions may include vomiting, diarrhea, decreased appetite, dark or tarry stools, increased water consumption, increased urination, pale gums due to anemia, yellowing of gums, skin or white of the eye due to jaundice, lethargy, incoordination, seizure, or behavioral changes. Serious adverse reactions associated with this drug class can occur without warning and in rare situations result in death (see Adverse Reactions). Owners should be advised to discontinue PREVICOX therapy and contact their veterinarian immediately if signs of intolerance are observed. The vast majority of patients with drug-related adverse reactions have recovered when the signs are recognized, the drug is withdrawn, and veterinary care, if appropriate, is initiated. Owners should be advised of the importance of periodic follow-up for all dogs during administration of any NSAID. CLINICAL PHARMACOLOGY: Mode of action: PREVICOX (firocoxib) is a cyclooxygenase-inhibiting (coxib) class, non-narcotic, non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory and analgesic properties. There are two main cyclooxygenase enzymes, COX-1 and COX-2, and a newly discovered third enzyme, COX-3, which has yet to be fully characterized.1 Cyclooxygenase-1 (COX-1) is the enzyme responsible for facilitating constitutive physiologic processes, e.g., platelet aggregation, gastric mucosal protection, and renal perfusion.2 It also is constitutively expressed in the brain, spinal cord, and reproductive tract.3 Cyclooxygenase-2 (COX-2) is responsible for the synthesis of inflammatory mediators, but it is also constitutively expressed in the brain, spinal cord and kidneys.4, 5, 6 Cyclooxygenase-3 (COX-3) is also constitutively expressed in the canine and human brain and also the human heart.7 Results from in vitro studies showed firocoxib to be highly selective for the COX-2 enzyme when canine blood was exposed to drug concentrations comparable to those observed following a once-daily 5 mg/kg oral dose in dogs.8 However, the clinical significance of these findings has not been established. EFFECTIVENESS: Two hundred and forty-nine dogs of various breeds, ranging in age from 11 months to 20 years, and weighing 13 to 175 lbs, were randomly administered PREVICOX or an active control drug in two field studies. Dogs were assessed for lameness, pain on manipulation, range of motion, joint swelling, and overall improvement in a non-inferiority evaluation of PREVICOX compared with the active control. At the study’s end, 87% of the owners rated PREVICOX-treated dogs as improved. Eighty-eight percent of dogs treated with PREVICOX were also judged improved by the veterinarians. Dogs treated with PREVICOX showed a level of improvement in veterinarian-assessed lameness, pain on palpation, range of motion, and owner-assessed improvement that was comparable to the active control. The level of improvement in PREVICOX-treated dogs in limb weight-bearing on the force-plate gait-analysis assessment was comparable to the active control. In a separate field study, two hundred fifty-eight client-owned dogs of various breeds, ranging in age from 10.5 weeks to 16 years and weighing from 7 to 168 lbs, were randomly administered PREVICOX or a control (sham-dosed-pilled) for the control of postoperative pain and inflammation associated with soft-tissue surgical procedures such as abdominal surgery (e.g. ovariohysterectomy, abdominal cryptorchidectomy, splenectomy, cystotomy) or major external surgeries (e.g. mastectomy, skin tumor removal > 8 cm). The study demonstrated that PREVICOX-treated dogs had significantly lower need for rescue medication than the controls (sham-dosed-pilled) in controlling postoperative pain and inflammation associated with soft-tissue-surgery. PALATABILITY: PREVICOX Chewable Tablets were rated both convenient to administer (97.2%) and palatable to the dog (68.5%) by owners in multi-center field studies involving client-owned dogs of various breeds and sizes. ANIMAL SAFETY: In a target animal safety study, firocoxib was administered orally to healthy adult Beagle dogs (eight dogs per group) at 5, 15, and 25 mg/kg (1, 3, and 5 times the recommended total daily dose) for 180 days. At the indicated dose of 5 mg/kg, there were no treatment-related adverse events. Decreased appetite, vomiting, and diarrhea were seen in dogs in all dose groups, including unmedicated controls, although vomiting and diarrhea were seen more often in dogs in the 5X dose group. One dog in the 3X dose group was diagnosed with juvenile polyarteritis of unknown etiology after exhibiting recurrent episodes of vomiting and diarrhea, lethargy, pain, anorexia, ataxia, proprioceptive deficits, decreased albumin levels, decreased and then elevated platelet counts, increased bleeding times, and elevated liver enzymes. On histopathologic examination, a mild ileal ulcer was found in one 5X dog. This dog also had a decreased serum albumin which returned to normal by study completion. One control and three 5X dogs had focal areas of inflammation in the pylorus or small intestine. Vacuolization without inflammatory cell infiltrates was noted in the thalamic region of the brain in three control, one 3X, and three 5X dogs. Mean ALP was within the normal range for all groups but was greater in the 3X and 5X dose groups than in the control group. Transient decreases in serum albumin were seen in multiple animals in the 3X and 5X dose groups, and in one control animal. In a separate safety study, firocoxib was administered orally to healthy juvenile (10-13 weeks of age) Beagle dogs at 5, 15, and 25 mg/kg (1, 3, and 5 times the recommended total daily dose) for 180 days. At the indicated (1X) dose of 5 mg/kg, on histopathologic examination, three out of six dogs had minimal periportal hepatic fatty change. On histopathologic examination, one control, one 1X, and two 5X dogs had diffuse slight hepatic fatty change. These animals showed no clinical signs and had no liver enzyme elevations. In the 3X dose group, one dog was euthanized because of poor clinical condition (Day 63). This dog also had a mildly decreased serum albumin. At study completion, out of five surviving and clinically normal 3X dogs, three had minimal periportal hepatic fatty change. Of twelve dogs in the 5X dose group, one died (Day 82) and three moribund dogs were euthanized (Days 38, 78, and 79) because of anorexia, poor weight gain, depression, and in one dog, vomiting. One of the euthanized dogs had ingested a rope toy. Two of these 5X dogs had mildly elevated liver enzymes. At necropsy all five of the dogs that died or were euthanized had moderate periportal or severe panzonal hepatic fatty change; two had duodenal ulceration; and two had pancreatic edema. Of two other clinically normal 5X dogs (out of four euthanized as comparators to the clinically affected dogs), one had slight and one had moderate periportal hepatic fatty change. Drug treatment was discontinued for four dogs in the 5X group. These dogs survived the remaining 14 weeks of the study. On average, the dogs in the 3X and 5X dose groups did not gain as much weight as control dogs. Rate of weight gain was measured (instead of weight loss) because these were young growing dogs. Thalamic vacuolation was seen in three of six dogs in the 3X dose group, five of twelve dogs in the 5X dose group, and to a lesser degree in two unmedicated controls. Diarrhea was seen in all dose groups, including unmedicated controls. In a separate dose tolerance safety study involving a total of six dogs (two control dogs and four treated dogs), firocoxib was administered to four healthy adult Beagle dogs at 50 mg/kg (ten times the recommended daily dose) for twenty-two days. All dogs survived to the end of the study. Three of the four treated dogs developed small intestinal erosion or ulceration. Treated dogs that developed small intestinal erosion or ulceration had a higher incidence of vomiting, diarrhea, and decreased food consumption than control dogs. One of these dogs had severe duodenal ulceration, with hepatic fatty change and associated vomiting, diarrhea, anorexia, weight loss, ketonuria, and mild elevations in AST and ALT. All four treated dogs exhibited progressively decreasing serum albumin that, with the exception of one dog that developed hypoalbuminemia, remained within normal range. Mild weight loss also occurred in the treated group. One of the two control dogs and three of the four treated dogs exhibited transient increases in ALP that remained within normal range. STORAGE: Store at room temperature, between 59°–86° F (15°–30° C). Brief periods up to 104° F (40° C) are permitted. To request a Material Safety Data Sheet (MSDS), call 1-877-217-3543. HOW SUPPLIED: PREVICOX is available as round, beige to tan, half-scored tablets in two strengths, containing 57 mg or 227 mg firocoxib. Each tablet strength is supplied in 10-count and 30-count blister packages and 60-count bottles. For customer service, please contact Merial at 1-888-637-4251. 1 2 3 4 5 6
*Sham-dosed (pilled) POST APPROVAL EXPERIENCE: The following adverse reactions are based on voluntary post-approval reporting and are consistent with those reported for other cyclooxygenase inhibitory NSAID class drugs. The categories are listed in decreasing order of frequency by body system.
®PREVICOX is a registered trademark of Merial. ©2008 Merial Limited, Duluth, GA. All rights reserved. PVX08CNPORCHSGLAD.
7 8
Willoughby DA, Moore AR and Colville-Nash PR. COX-1, COX-2, and COX-3 and the future treatment of chronic inflammatory disease. Lancet 2000;355:646-648. Smith, et al., Pharmacological Analysis of Cyclo-oxygenase-1 in Inflammation. Proc. Natl. Acad. Sci. USA, Pharmacology 1998;95:13313-13318. Jones CJ and Budsberg SC. Physiologic characteristics and clinical importance of the cyclooxygenase isoforms in dogs and cats. JAVMA 2000;217(5):721-729. Zhang, et al., Inhibition of Cyclo-oxygenase-2 Rapidly Reverses Inflammatory Hyperalgesia and Prostaglandin E2 Production. JPET 1997;283:1069-1075. Jones and Budsberg, pp. 721-729. Zhang, et al., pp. 1069-1075. Chandrasekharan NV, Dai H, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/ antipyretic drugs: Cloning, structure and expression. Proc. Natl. Acad. Sci. USA, 2002;99(21):13926-13931. Data on file. Merial Limited 3239 Satellite Blvd. Duluth, GA 30096-4640 U.S.A. 1-877-217-3543
U.S. Patent Nos. 5,981,576; 6,541,646; and 6,677,373 NADA 141-230, Approved by FDA 1050-1727-05 Rev.11-2007
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predictability can lead to stress or anxiety, so interactions between the owner and the pet should be characterized by consistency. Just as is true with people, if cats follow a predetermined schedule of interactions with the owner, they are much more relaxed. The owner–cat interactions do not have to occur at the same time every day, but they should happen in the same order to create a routine. To build consistency of human–cat interactions, they should be in the form of cue–respond–reward. The owner should have the cat “sit” or “come” before initiating any other interaction. Yes, cats can learn cues! Some training with treats — and possibly a clicker — should be incorporated into play and training sessions. Clicker training is a form of behavior modification in which a clicker is used to mark the desired behavior. Avoid conditioning the behavior: Owners may inadvertently reinforce the grooming behavior by giving undue attention to the cat’s actions. Petting or consoling the cat as a means of interrupting the behavior should be avoided. Withdraw attention: If the owner has been inadvertently reinforcing the behavior, suggest that he or she avoid eye contact and walk away from the cat when it performs the behavior. Avoid punishment: Using verbal reprimands (“No!”) or physical punishment (swat on the nose, water spray, shake can) for undesirable behaviors can increase anxiety and exacerbate psychogenic grooming. Use response substitution: Ideally, before the behavior occurs or while the cat is involved in excessive grooming, the owner can interrupt the behavior without inducing fear or stress. For example, the owner can call the cat by its name or, again without causing stress or fear, clap his or her hands. Once the cat’s behavior has been interrupted, the www.VetTechJournal.com
owner should give the cat cues that have previously been taught, such as “come” and “sit,” and reward the acceptable behavior by giving the cat either a treat or toy. To prevent the cat from returning to its previous grooming behavior, the owner may need to redirect the cat’s attention for a considerable time.
Environmental Modification Decrease social competition: In multicat households, it is important to provide numerous food, water, and resting areas, several litter box stations, and ample vertical living space, such as cat trees, window perches and platforms. Feed ad libitum: Cats are solitary hunters and prefer to eat frequent small meals. Food storage devices, such as puzzle feeders, can be provided to encourage cats to work for their food. Encourage exploratory behavior: Small treats can be hidden throughout the home to stimulate hunting behavior. Place four to six small dishes in various locations, keeping half of them full and half of them empty. Rotate toys, and have scheduled play sessions: If the cat’s toys are rotated, they will remain novel to the cat. However, not all cats instinctively know how to play with toys. If the owner provides scheduled play sessions with a toy that stimulates hunting and chasing behavior, most cats can be induced to play. Consider indoor environmental enrichment: An indoor cat garden, fish tank, or interactive videos also can keep a cat stimulated. Consider pheromone therapy to reduce social stress: Pheromone therapy (Feliway, Ceva Santé Animale, Libourne, France) can be considered to minimize social stress. Feliway is a synthetic analogue of the feline facial pheromone.
Medication If the veterinarian has diagnosed an anxiety- or fear-based disorder, such
as separation anxiety or compulsive disorder, antianxiety or anticompulsive medication may be indicated. Tricyclic antidepressants, such as clomipramine, or selective serotonin reuptake inhibitors, such as fluoxetine and paroxetine, are most commonly used to treat disorders of compulsive etiology. If there is a pruritic component to the behavior in addition to an anxiety component, the tricyclic antidepressants doxepin and amitriptyline may be considered. Although they are excellent antihistamines, doxepin and amitriptyline are not selective for serotonin uptake inhibition and are not, therefore, anticompulsive.
References
1. Virga V. Behavioral dermatology. Vet Clin North Am Small Anim Pract 2003;33: 231-251. 2. Scott DW, Miller WH, Griffen CE. Small Animal Dermatology. 6th ed. Toronto: WB Saunders; 2001:625, 1066-1069. 3. Waisglass SE, Landsberg GM, Yager JA, Hall JA. Underlying medical conditions in cats with presumptive psychogenic alopecia. JAVMA 2006;228:1705-1709. 4. Landsberg GM, Hunthausen W, Ackerman L. Stereotypic and compulsive disorders. In: Handbook of Behavior Problems of the Dog and Cat. Edinburgh: WB Saunders; 2003:195-225. 5. Garg A, Chren MM, Sands LP, et al. Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the pathogenesis of stressassociated skin disorders. Arch Dermatol 2001;137(1):53-59. 6. Luescher AU. Diagnosis and management of compulsive disorders in dogs and cats. Vet Clin North Am Small Anim Pract 2003;33:253-267.
For more information: To access additional information on clicker training, visit www.clickertraining.com.
Send Ask the TECHspert questions to: Email: editor@VetTechJournal.com Fax: 800-556-3288 Mail: VLS/Veterinary Technician
780 Township Line Road Yardley, PA 19067 Veterinary Technician | AUGUST 2008
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TechTips
TIP of the MONTH
Each published Tip of the Month contributor receives a Veterinary Technician® scrub top in addition to $50.
At my clinic, we keep a set of “normal” radiographs, including those of a healthy animal’s chest, abdomen, spine and bladder, to use when explaining abnormal radiographic findings to clients. Showing radiographs with and without abnormalities side by side can help clients better understand their pet’s condition. Kim Becker, LVT East Aurora, N.Y.
Tricks of the Trade To remove air bubbles from a fluid line, occlude the line below the bubble, then remove the line from the IV fluid pump. Starting from above the stopper, wrap the line around a highlighter or thick marker. This will force the air bubbles back into the bag. Carrie Santare, LVT Ithaca, N.Y. When a client has to bring home several syringes containing oral medications, put a cap on the syringes and place them in a 60-ml syringe case. This will prevent the liquid from spilling en route. Tammy MacLeod, RVT, VTS (ECC) Moncton, New Brunswick, Canada
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TechTips My clinic doesn’t have separate waiting areas for dogs and cats, and our feline patients often become frightened by the dogs. To help with this situation, I purchased a 3-panel foam presentation board to place in front of the cat’s carrier. This makes the cat feel more secure until it can be taken to an examination room. Laure VanAsselt Canton, Mich.
Marker Magic I created a quick, accurate way to record a veterinarian’s instructions when preparing a prescription. On a 3 × 5 index card, I made columns labeled “Drug,” “Dosage,” “Directions” and “Count.” I then laminated the card, which I keep in my
Circle 171 on Reader Service Card
pocket with a dry-erase marker. When the veterinarian needs to give prescription information quickly, I write it on the card, prepare the prescription and then erase the card. Sandra Szalkiewicz, CVT Wauconda, Ill. We created feline and canine dental charts, which we laminated. While charting during a dental cleaning, we label the charts using dry-erase markers. This makes it easy for us to indicate which teeth we think the doctor should examine or extract. We then transfer the charting information into the patient’s file. This way, we save time and avoid wasting paper. Christina Mayes, RVT Clyde, Ohio
We created laminated invoice sheets (green for dogs and yellow for cats) that list codes and descriptions of each procedure our clinic offers. When the doctor finishes examining or treating a patient, he or she uses a dry-erase marker to circle the appropriate codes. The receptionist creates an invoice and wipes off the invoice sheet. Lesley Amundson, RVT, and Kaly Coleman, RVT Regina, Saskatchewan, Canada If you accidentally use a permanent marker on a dry-erase board, simply scribble over the mark with a dry-erase marker. You will then be able to erase both marks. Tammy MacLeod, RVT VTS (ECC) Moncton, New Brunswick, Canada
TECH TIP CHALLENGE $50 paid for each
? published response!
How do you discourage owners from allowing their dog to beg for food? Deadline for responses: Sept. 15
Answers to ourTechTip Challenge or otherTechTip 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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ClinicalNutrition
The Buzz on
Nutrigenomics
T
HE ROLE OF THE VETERINARY TECHNICIAN as patient caretaker and client educator is constantly growing — you are the front line in reinforcing your veterinarian’s recommendations to clients. When new fields of science emerge and evolve, it is imperative that you grasp an overall understanding of how they can be applied at a practice level.
Glossary Chromosome Organized structure of DNA and proteins found in cells; formed from a single DNA molecule that contains many genes Gene Sequence of genetic material or DNA; the fundamental unit of heredity Genome Full complement of DNA in an organism; includes all of the chromosomes Genomics Study of genomes, including genome mapping and sequencing Genotype Full complement of genes inherited by an individual animal Nutrigenomics The science that looks at how nutrients and food interact with genes and affect gene expression Phenotype Outward or physical appearance
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One new buzzword in the veterinary profession is nutrigenomics. In 2004, the National Institutes of Health (NIH) completed the mapping of the canine genome, and the feline genome mapping project is under way.1 This mapping, in conjunction with the knowledge that progression from a healthy state to a disease state may be accompanied by a change in gene expression, is an emerging science in veterinary medicine. Nutrigenomics looks at the interaction of nutrients and food with genes. It offers a molecular awareness of how common dietary nutrients can influence a pet’s gene expression and possibly the pet’s overall health as well as a better understanding of how to regulate metabolic pathways to optimize the health of companion animals. Because of advances in companion animal medicine, including nutrition, dogs and cats are living longer. But they also are suffering more often from many of the same diseases that affect older owners. In human medicine, dogs and cats are used as animal models for the same genetic and nutritional diseases that humans suffer. Dogs in particular are animal models for such conditions as arthritis, various cancers, heart disease, and chronic metabolic diseases, including obesity and diabetes.2 Because there is a genetic component for these diseases, nutrigenomics may play a role in their management. For example, dogs are becoming more obese for the same reasons that humans are — a potential genetic predisposition com-
AUGUST 2008 | Veterinary Technician
Kara M. Burns, MS, MEd, LVT Hill’s Pet Nutrition Topeka, Kan.
bined with reduced daily exercise and increased caloric consumption.1–3 Therefore, it makes sense that disease conditions with both a genetic component and a nutritional component can begin to be addressed through nutrigenomics and that companion animals may serve as the nutrigenomic model for obesity in humans. It is important for you to recognize which conditions could be influenced by nutrigenomics and how this emerging field may someday influence their management.
Osteoarthritis One disease condition affecting both dogs and humans is osteoarthritis (OA), also referred to as degenerative joint disease — a chronic, progressive disease distinguished by pathologic changes to movable joints. OA is associated with degeneration of articular cartilage and loss of proteoglycan and collagen, production of new bone, and a variable inflammatory response. These changes are accompanied by clinical signs, typically manifested as pain and disability associated with the affected joint. OA is the most common cause of lameness in dogs and has been estimated to affect up
FASTFACT
Approximately 24% to 30% of dogs and cats presenting to small animal hospitals in North America are overweight or obese.6 www.VetTechJournal.com
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Wet and wild doesn’t mean losing protection.
Advantage® and K9 Advantix® are waterproof. Go ahead, get wet — with th Advvantage e aand K9 Ad dvantix. Both are water erproo of. You can be confident that after your patien nts swi wim m or b bathe, th hey ey’rre still protec ecte ted from biting g pests. To learn more, please contact your Baaye y r Anim imal Hea ealth Consultant at 1-800-63 633-3796 96.
K9 Advantix is for use on dogs only. © 2008 Bayer HealthCare LLC, Animal Health Division, Shawnee Mission, Kansas 66201. Bayer, the Bayer Cross, K9 Advantix and Advantage are trademarks of Bayer.
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ClinicalNutrition to 20% of dogs 1 year of age and older.3 As a member of the health care team, you are involved in controlling and/or managing the disease progression, including incorporating proper nutrition, weight control, physical therapy, controlled exercise, and pain medication and analgesia. Studies of the use of omega-3 fatty acids derived from fish oil and flaxseed, specifically eicosapentaenoic acid (EPA), in the management of OA have found positive clinical benefits, including controlling inflammation and reducing the expression and activity of cartilage proteoglycan-degrading enzymes.4 In other words, EPA has been found to turn off one of the genes
that causes cartilage degradation4 and to disrupt the cycle of inflammation. This can result in improved clinical signs, including less pain, increased range of motion, and improved weight bearing. Visible improvement in arthritic signs were apparent to the owners of dogs in one study.5
Obesity In pets 5 to 12 years of age, 42% of adult dogs and 44% of adult cats are overweight or obese.6 Weight management is, therefore, at the forefront of owner education, so your role as educator is critical. The health risks associated with obesity in pets, including OA, dia-
Nutrition’s Effect on Genes A brief review of genetics can help you understand how pets become susceptible to inherited problems and how these problems may be diagnosed and treated. Genes are sequences of genetic material, otherwise known as deoxy ribonucleic acid (DNA). These genes are found on chromosomes and supply directions for the body to produce structural proteins, enzymes, and other molecules. The full complement of DNA is called the genome. The pet’s genotype is made up of the unique assortment of genes that the pet receives from each parent. We cannot visualize the genotype, but we can see the outward product of this genotype, which combined with environmental influences, makes up the phenotype — that is, each pet’s physical appearance. It is found that in both humans and dogs, the progression from a healthy phenotype to a chronic disease phenotype can occur through changes in gene expression or through differences in the activities of proteins and enzymes.9 Nutrition is one of the most important environmental factors affecting the physical characteristics or phenotype of an animal. Genetics or DNA affects how each pet responds to nutrition. Also, nutrition can influence gene expression. Historically, changes to gene expression that were attributed to nutrition were believed to occur typically through hormonal action or the nervous system. More recently, research has shown that macronutrients, such as fatty acids and amino acids, in addition to such micronutrients as zinc, iron, and vitamins, can regulate gene expression.1 Carotenoids, flavonoids, and phenolic acids are bioactive food components believed to act as transcription factors directly affecting gene expression. 492
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betes, and respiratory distress, and the health benefits of a normal or lean body weight, including length and quality of life, have been documented.6,7 A successful weight loss program is, in theory, very simple — reduce caloric intake and increase physical activity. However, as technicians, we are well aware of the lack of compliance when executing a weight loss program, and the perceived simplicity of the program does not necessarily correlate to actual weight loss. Of interest, the gene expression profiles for obese dogs are clearly different from those for lean dogs.7 Weight loss studies conducted in dogs have found positive effects on biomarkers — biochemical analyses — associated with obesity-related conditions.7 Weight loss in dogs also has been associated with a reduction in triglycerides, cholesterol, thyroxine, and leptin.8 By measuring traditional biomarkers and using genomics, we may gain a better understanding of the mechanisms involved that can enable us to aid in the prevention and/or early treatment of obesity and obesity-related diseases. Scientists have linked obesity to other diseases through molecular analysis of lean and fat tissue and lymphocyte samples. A recent study looked at the effects of weight loss on the gene expression profiles of obese dogs. These dogs were fed a dry, lowfat, fiber-enhanced therapeutic food for 4 months. On average, the dogs lost 41.2% of their initial fat mass in that time.7,8 The nutrigenomic effect from the food was seen in the shift from an obese to a lean gene expression profile. The genes that were identified showed down-regulation or a “turning off” of genes associated with fat accumulation once the dogs lost weight. The study showed that the metabolism shifted in obese dogs fed the weight loss food to a lean genomic profile. The effect of weight loss on the gene expression profile for obese cats also has been studied.8 For a 4-month www.VetTechJournal.com
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It’s insurance for pets, but some of
the benefits are yours. PurinaCare™ Pet Health Insurance is another example of our passionate commitment to pets and the people who care for them—people like you. For a sample policy visit PurinaCare.com, you’ll see that PurinaCare’s comprehensive and affordable coverage helps give your clients the financial resources to take advantage of all the expertise, technology and compassion your practice has to offer.
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Pe t H e a l t h I n s u r a n c e to learn more visit PurinaCare.com
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Circle 135 on Reader Service Card (1-877-838-2255)
Trademarks owned by Société des Produits Nestlé S.A. and used by PurinaCare Insurance Services, Inc. with permission of the trademark owner. Insurance services offered by PurinaCare Insurance Services, Inc. Producer licensing pending in some jurisdictions. Insurance underwritten by member companies of American International Group, Inc. Issuance of coverage subject to underwriting review and approval. The description herein is a summary only. It does not include all terms, conditions and exclusions of the coverage described. Please refer to the actual policy for complete details of coverage and exclusions. Coverage may not be available in all jurisdictions. For availability, please visit purinacare.com.
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ClinicalNutrition period, cats were fed a low-fat, highfiber, dry therapeutic food. On average, cats lost 30.7% of their initial fat mass. The nutrigenomic effect of the food was seen in the down-regulation of genes associated with inflammation, obesity, and type 2 diabetes mellitus. This study supported the theory that weight loss can correct the systemic effects of obesity.8,10 Obesity is more than just a weight issue. Increased weight and the associated biochemical changes increase susceptibility to other diseases, including OA, diabetes, and respiratory distress. Weight loss appears to reverse many of the changes that occur with obesity. Therefore, it is important that you repeatedly remind owners about the benefits of maintaining their pets at an ideal weight.8
Geriatric Cognitive Dysfunction Although the genetic aging process cannot be altered, by understanding
gene expression, the suppression of free radicals, and the changes that coincide with aging, you may be able to help owners improve the pet’s quality of life. As dogs age, their cognitive abilities are found to decline. The decline in brain function is associated with changes in the brain tissue, which is found to shrink over time. One potential cause of the changes is oxidative damage from toxic free radicals. It has been shown that key nutrients may play a role in stopping and reversing the cognitive decline. These key nutrients include antioxidants, such as vitamins E and C, selenium, and beta-carotene, as well as carotenoids and flavonoids, which work together to quench free radicals; lipoic acid and L-carnitine, which support efficient energy production; and omega-3 fatty acids — docosahexaenoic acid or DHA — which help nourish brain tissue.11 A clinical study
found that dogs fed the supplemented diet showed enhanced learning ability and reduced oxidative damage.11 The dogs reportedly showed improvement in signs of cognitive dysfunction.12,13 Aging is an inevitable process that is controlled by genes and influenced by nutrition. Older dogs and cats can experience improved quality of life and a potentially longer life if fed a food that provides critical nutrients, such as antioxidants, omega-3 fatty acids, and possibly fruits and vegetables, which have been shown to influence gene expression.13–18
Nutrigenomics in Everyday Practice The field of genomics ushers in a profound new era that gives scientists an extraordinary glimpse into the body’s metabolism. Understanding the relationship among genes, nutrients, and health holds the potential for veterinary professionals to change the treatment approach in
Nutrigenomics for Puppies and Kittens One of the most dynamic influences on the growth of puppies and kittens is nutrition. The role of nutrition in alleviating developmental orthopedic disease (DOD) in dogs has been well documented. In large-breed dogs, studies have shown that the rate of growth, specific nutrients, food consumption, and feeding methods may influence the incidence of DOD.13–17 The beneficial effects of limiting energy, calcium, and phosphorus on the expression of skeletal disease also have been established. Supplementing growth foods with docosahexaenoic acid (DHA) and feeding them to the bitch during pregnancy and lactation reportedly can affect certain markers of brain development: trainability, problem-solving tasks, and electroretinogram activity — a marker of brain development.13–16 Amino acids, calcium–phosphorous ratio, vitamins, and other minerals can have a positive effect on musculoskeletal growth in kittens. Supplementing the queen’s foods with DHA during pregnancy and lacta-
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tion improved electroretinogram activity and accumulation of DHA in the brain of kittens.13 Studies also have shown that a complex mixture of omega-3 fatty acids, antioxidants, and other developmental nutrients resulted in reduced body fat and improved the indicators of antioxidant status in large-breed puppies.17 Another study showed that weaned puppies fed a complex mixture of DHA, antioxidants, and other neural development supportive nutrients showed significant improvement in cognitive and motor function tests and an improved immune response to vaccination.18
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FASTFACT
9. Ackerman L. The basics of inheritance. The genetic connection: a guide to health problems. In: Purebred Dogs. Lakewood, Colo.: AAHA Press; 1999:1-29. 10. Yamka RM, Friesen KG. Identification of markers related to feline obesity. J Anim Sci 2006;84(Suppl 1):171-172. 11. Milgram NW, Head E, Zicke SC, et al. Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortification: a two year longitudinal study. Neurobiol Aging 2005; 26:77-90.
One of every two dogs
older than 8 years of age suffers from age-associated behavioral changes.11 pets.11 Applying the concept of nutrigenomics to pet nutrition could become an important step in improving the quality of life of our companion animals. Acknowledgment: The author wishes to thank Philip Roudebush, DVM, DACVIM, for his complimentary review of this article.
References
1. Vester BM, Swanson K. Nutrient-gene interactions: application to pet nutrition and health. Vet Focus 2007;17:25-32. 2. Swanson KS, Schook LB, Fahey GC Jr. Nutritional genomics: implications for companion animals. J Nutr 2003;30333040.
3. Johnston SA. Osteoarthritis: joint anatomy, physiology and pathobiology. Vet Clin North Am Small Anim Pract 1997;27:699-723. 4. Caterson B, Little CB, Cramp J, et al. Eicosapentaenaote supplementation abrogates canine articular cartilage degradation in ‘in vitro’ explant culture systems. In: Proceedings: Hill’s European Symposium on Osteoarthritis and Joint Health. Geneva: Hill’s Pet Nutrition; 2005:14-19.
Omega-3 fatty acids in canine osteoarthritis: a randomized, double masked, practice based study, 6 month feeding study, 2003. In: Clinical Evidence Report: Canine Osteoarthritis and Omega-3 fatty Acids (TD – 827). Topeka, Kan.: Hill’s Pet Nutrition; 2005. 6. Armstrong PJ, Lund EM. Changes in body composition and energy balance with aging. Vet Clin Nutr 1996;3:83-87. 7. Yamka R, Friesen KG, Gao X, et al. The effects of weight loss on gene expression in dogs (abstract). J Vet Intern Med 2008;22:741. 8. Armstrong PJ, Yamka RM. Obesity’s missing link: the union of metabolism, genome and disease. In: Proceedings: Hill’s Nutrigenomic Symposium, 2008 AVMA Conference. Available at www. HillsVet.com.
12. Zicker SC, Schoenherr WD, Frantz NZ, et al. Feeding for the future: new genomic insights and implications for puppies and kittens. In: Proceedings: Hill’s Nutrigenomics Symposium, 2008 AVMA Conference. Available at www. HillsVet.com. 13. Roudebush P, Zicker SC, Cotman CW, et al. Nutritional management of canine brain aging. JAVMA 2005;227:722-728. 14. Heinemann KM, Waldron MK, Bigley KE, et al. Long-chain (n-3) polyunsaturated fatty acids are more efficient than alpha-linolenic acid in improving electroretinogram responses of puppies exposed during gestation, lactation, and weaning. J Nutr 2005;135:1960-1966. 15. Heinemann KM, Bauer JE. Docosahexaenoic acid and neurologic development in animals. JAVMA 2006;228: 700-705. 16. Kelley RL, Lepine AJ, Burr JR, et al. Effect of dietary fish oil on puppy trainability (abstract). Workshop 6th Intl Soc Study Fatty Acids Lipids Congr 2004:51. 17. Zicker SC, Jewell DE, Yamka RM, et al. Improved learning, psychomotor and physiologic functions may be attributed to post-weaning dietary fortification in growing Beagle puppies. JAVMA, submitted for publication, 2008. 18. Khoo C, Cunnick J, Friesen K, et al. The role of supplementary dietary antioxidants on immune response in puppies. Vet Ther 2005;6:43-56.
As a veterinary technician specialist at Hill’s Pet Nutrition, Kara is involved with educating technicians about the role of nutrition. In addition to nutrition, Kara M. Burns, and specifically the emerging role of nutrigenomics, MS, MEd, LVT her professional interests include behavior, dentistry, oncology, and research. She is actively involved in a number of organizations, including NAVTA, and serves as co-chair of the AAHA Conference Development Committee, as technician liaison for AAVN, on the staff utilization committee for NCVEI, and as a board member of the Veterinary Technician Cancer Society. ABOUT THE AUTHOR
5. Dodd CE, Fritsch DA, Allen TA, et al.
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StateNews ARIZONA
on whether it will administer a test for state licensure to candidates trained on the job. The Oregon Veterinary Technician and Assistant Association’s executive board is in the process of responding to this issue.
Brandy Sprunger, CVT, (far left) past president of the Veterinary Health Care Team of Arizona, presents the Veterinary Health Care Team of the Year Award to First Emergency Pet Care located in Gilbert: (left to right) Lisa Kernaghan, CVT, Tatijuana McMahon, CVT, and Maryanne Clark, CVT.
NEW JERSEY After more than 20 years of registering technicians, the New Jersey Veterinary Medical Association (NJVMA) is discontinuing its program of voluntary registration at the end of 2008. This program offered registered veterinary technician status to those who had graduated from an AVMAaccredited program, passed the Veterinary Technician National Examination (VTNE) and maintained their registration status. Registration, however, conferred no legal status and did not affect whether a technician or assistant could work in New Jersey. New Jersey Veterinary Technicians and Assistants (NJVTA) is forming a committee to assume the registration of technicians, as well as a task force to look into the possibility of licensing technicians. The VTNE will continue to be offered in New Jersey. OREGON Veterinary technicians trained on the job may be affected by a recent ruling of the American Association of Veterinary State Boards (AAVSB) that will require technicians to graduate from an AVMA-accredited veterinary technology program before they are eligible for licensing. The Oregon Veterinary Medical Board has yet to rule
PENNSYLVANIA The ASPCA recently implemented the Philadelphia Rescue Assistance Program (Philly RAP) to support approved rescue groups that receive animals transferred from the Philadelphia Animal Care and
Control Association (PACCA). Through Philly RAP, the ASPCA will donate $70,000 to its recognized rescue partners that accept animals from PACCA. After an at-risk animal is transferred to a rescue partner, spayed or neutered and adopted, a $25 subsidy will be disbursed. Rescue partners also will receive $250 for medical expenses between $500 and $2,000 and will receive $500 for medical expenses over $2,000. For more information on this program, visit www.aspcapro.org.
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For a demonstration call 1-800-MIDMARK or an authorized Midmark Veterinary dealer. midmark.com
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ManagementMatters
Finding the Right Staff
A
Katherine Dobbs, RVT, CVPM, PHR interFace Veterinary HR Systems, LLC Appleton, Wis.
N OUTSTANDING HEALTH CARE TEAM is the key to a successful clinic. All members of the team have to work together to provide high-quality client service and patient care. Therefore, as a practice manager, one of your most important roles is hiring qualified, team-oriented staff members. The steps below will help guide you in your search for a winning team. Create a Job Description
Free download! To learn about the pros and cons of using the various recruitment methods, visit VetTechJournal.com.
The first step to hiring a new employee is creating a job description. This should include the position title, a summary of the position, a list of duties and responsibilities, a description of the skills and qualifications needed and the title of the employee’s supervisor.a The job description should be specific yet flexible enough to encourage a variety of qualified candidates to apply. Current staff members can help ensure that the job description is accurate and up-to-date, so it’s beneficial to ask for their input during this process.
Advertise the Position
Katherine Dobbs, RVT, CVPM, PHR Katherine is the regular author of Management Matters. She is the founder of the Veterinary Emergency and Specialty Practice Association (www.vespa-home.org), which is dedicated to helping emergency and specialty practice managers and other veterinary professionals manage their clinics more effectively. She recently started her own consulting business, interFace Veterinary HR Systems, LLC. If there is a topic that you would like Katherine to address, contact her directly at ManagementMatters@sbcglobal.net. 498
After you’ve created the job description, you’ll want to ensure that you get the best pool of candidates. When advertising the position, don’t overlook qualified candidates within the practice. By allowing current employees to apply for the job before it’s advertised to the public, you’ll motivate your staff and encourage them to take advantage of the practice’s advancement opportunities. When advertising the job to the public, you may use a variety of print media, as well as alternative recruitment methods (see box above). Your goal should be to reach out to as many qualified applicants as possible. a
For more information on job descriptions, see “Creating Accurate Job Descriptions” in our April 2007 issue, available online at www.VetTechJournal.com.
AUGUST 2008 | Veterinary Technician
Get the Word Out! Because veterinary medicine is a quickly growing field, there are many ways to recruit new staff: Online job listings Your practice’s website Employment/recruitment agencies High schools, colleges and/or trade schools Current employees and personal/professional contacts Newspapers, professional journals and association newsletters
Evaluate the Applicants Once you begin receiving résumés, you should categorize them based on how well each candidate meets the requirements outlined in the job description. This will allow you to eliminate candidates who don’t meet the minimum requirements for the job. When selecting which candidates to interview, also consider the cover letter. It should give you an idea of the candidate’s professionalism, ability to communicate and interest in the position.
Conduct Interviews After you’ve selected the applicants who meet the qualifications for the position, begin the interview process. You may find it easier to conduct interviews in the following stages: www.VetTechJournal.com
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ManagementMatters Contact the candidate by phone. It is helpful to schedule a short phone interview with each candidate. During the interview, pay attention to the individual’s enthusiasm, response to your questions and professionalism while speaking. Conduct a face-to-face interview. Candidates who impress you during the phone interview can be asked to come to the clinic for a more in-depth interview. During this interview, be sure to inform each candidate of the mission and core values of the
practice. While you’re describing the requirements of the position, ask candidates to explain how their skills and experience make them qualified for the job. Also ask candidates openended questions about difficult situations that they have faced in previous jobs and how they resolved them.b It is important to consider not only how candidates answer all the questions but also whether they make eye contact and communicate in a professional manner.
a few candidates, you may want to schedule working interviews with each of them. Conducting a working interview allows you to confirm that a candidate has the skills required for the position, is able to learn quickly and interacts well with other team members. If you choose not to have a working interview, consider inviting each candidate to spend a few hours interacting with and observing the current staff.
Arrange a working interview. When you’ve narrowed down your choice to
Weigh Your Options
Three Interviewing Tips Tip 1 During the phone and/or face-to-face interview, use a form or checklist with questions to ask each candidate to help keep the conversation on track. Tip 2 Consider the candidate’s punctuality, professional attire and general disposition in your assessment. Tip 3 If you conduct working interviews, be sure you have considered the legal implications, such as compensation and insurance coverage. These requirements may vary by state.
b
For more information on interview questions, see “How to Avoid Asking Illegal Questions During an Interview” in our February 2008 issue, available online at www.VetTechJournal.com.
When making a hiring decision, consider how well each candidate met your expectations throughout the interview process. You also may conduct reference checks to verify a candidate’s education and experience. Encourage current staff members to offer input, based on their interactions with the candidates.
Conclusion It is important not to rush into a hiring decision. By carefully considering your choice, you’ll be more likely to select a team member who contributes to your clinic’s success.
Looking for great new products? Interested in the latest veterinary services? Check out Market Showcase starting on page 502! Visit
www.VetClassifieds.com to view all current products and services listings TODAY!
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ProductForum NAVTA/Fort Dodge Animal Health
Pet King Brands
To celebrate the veterinary technician as an integral part of the health care team, NAVTA is distributing a National Veterinary Technician Week (NVTW) poster. The poster, sponsored by Fort Dodge Animal Health, lists the 2008 NVTW theme — Vet Techs: The Heart of Pet Wellness — as well as the dates — Oct. 12 to 18. In addition, NAVTA will be expanding its public relations campaign for NVTW on its website. Posters can be obtained by contacting the NAVTA office at info@navta.net.
Pet King Brands has released Zymox Otic Enzymatic Solution in a 4-oz size. This size is convenient for owners of multiple pets, large breeds or animals with bilateral infections. Zymox Otic Enzymatic Solution, which is available with or without hydrocortisone, is a once-a-day treatment for bacterial and fungal ear infections.
National Veterinary Technician Week Poster
703-740-8737 www.navta.net Circle 101 on Reader Service Card
888-752-5487 www.petkingbrands.com Circle 102 on Reader Service Card
Vétoquinol USA
Canine Pain Relief Vetprofen, a prescription NSAID, is available from Vétoquinol USA. Vetprofen is designed to alleviate pain associated with osteoarthritis, as well as orthopedic and soft tissue postoperative pain. Vetprofen comes in 25-, 75- and 100-mg sizes in 240-count bottles. 800-267-5707 www.vetoquinolusa.com Circle 103 on Reader Service Card
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USB Identification Tag Portable Pet Profile introduces a USB flash drive encased in waterproof, stainless-steel casing. The drive attaches to the pet’s collar and contains the pet’s pertinent information, including vaccination history, allergies, owner and veterinarian contacts, personality characteristics and lab images. The drive fits into any USB port. 877-977-0389 www.portablepetprofile.com Circle 104 on Reader Service Card
(727) 27 7) 341-4SPC www.spcollege.edu/hec/vt w.spcollege.edu/hec/vt
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For more information about the products highlighted in this section, fill out and return the Reader Service Card inserted between pages 504 and 505 of this issue. The product and service descriptions presented in Product Forum are provided by the manufacturers and are not necessarily endorsed by Veterinary Technician.
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IndustryBriefs
FDA Issues Safety Warning About Comfortis and High-Dose Ivermectin Interaction The Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM) announced that it has received reports of adverse events in dogs receiving Comfortis (spinosad) concurrently with high, extralabel doses of ivermectin. The clinical signs associated with these events are consistent with ivermectin toxicity. Merial issued a statement reminding veterinarians that these adverse reactions are not associated with the use of Comfortis alone with approved ivermectin products used monthly for heartworm prevention. Comfortis, manufactured by Elanco Animal Health, a division of Eli Lilly and Company, is a monthly chewable tablet for the prevention and treatment of flea infestations on dogs. Veterinarians who use high, extralabel doses of ivermectin to treat dogs with nonresponsive demodectic mange and other conditions should be aware that some dogs have developed signs of ivermectin toxicity when extralabel ivermectin is used with Comfortis.
The CVM and Elanco said that dogs receiving extralabel doses of ivermectin should not receive concurrent treatment with Comfortis. For additional information, see the Elanco Animal Health website.
Novartis, Hill’s Partner to Fight OA Hill’s Pet Nutrition and Novartis Animal Health have partnered to launch the Multimodal Osteoarthritis Management Program to help veterinary health care teams improve the lives of their canine patients with impaired mobility from osteoarthritis (OA). The program will promote a comprehensive treatment plan, including nutrition, medication, exercise, rehabilitation and adjunct therapies. Hill’s and Novartis are introducing a multimodal kit that contains interactive educational tools designed for the entire veterinary team, pet owner materials and extra incentives that teams can use to encourage pet owners to seek veterinary care for their canine companions. Health care teams also can use the kit to raise awareness about joint health and mobility. For more information on Hill’s programs, visit VetTechJournal.com.
Index to Advertisers For more information about products advertised in this issue, see the Reader Service Card inserted between pages 504 and 505.
Company
Product
American College of Veterinary Internal Medicine American Kennel Club Animal Health Options ASPCA Bayer Animal Health Hill’s Pet Nutrition IDEXX Pharmaceuticals Lilly Merial
2009 ACVIM Forum
198
495
Companion Animal Recovery ID System Proanthozone Derm Animal Poison Control Center Advantage and K9 Advantix Prescription Diet r/d Canine Acarexx Reconcile Previcox PureVax and Vet Jet VetPro 1000 Purina Canine Treats Purina Veterinary Diets JM Joint Mobility Canine Formula Oxstrin Dexdomitor Pet Health Insurance Cardell Monitor Online Veterinary Technology Program Market Showcase and Classifieds TECHTALK VETERINARY TECHNICIAN Offers Free CE Opportunities Practice Communication and Marketing Tool
155 127 184
Cover 2 (US only) 469 453 491 Cover 2 (Canada only) 456, 457 458, 459 485, 486 463 497 Cover 3 488–489
Midmark Nestlé Purina PetCare
Nutramax Laboratories, Inc. Pfizer Animal Health PurinaCare Insurance Services Sharn Veterinary St. Petersburg College Veterinary Learning Systems
Vetstreet
Reader Service #
199 193 180 175 200 162 171 161 194 135 151 181
186
Page #
451 465, 466 493 Cover 4 500 499 509 455 (US only) 475, 477, 479, 481
The following advertisers appear in our Market Showcase section, which begins on page 502. Alpine Publications MED I.D. Petknap, Inc. Veterinary Solutions WhereTechsConnect.com
www.VetTechJournal.com
Dictionary of Veterinary Terms BIPS Capsules X-Ray Identification System Pet Burial Bags World’s Best Dog & Cat Muzzle Job Source and Marketplace for Vet Techs
118 120 120 121 122 123
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World’s Best Dog & Cat Muzzle The durable, soft plastic Vetsol cat & dog muzzle goes on easily, is comfortable, and stays put! Great for exams, drawing blood, taking x-rays, and grooming.
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For more information or to place an ad, Contact Linda Costantini Phone 800-426-9119, ext 52422, or 267-685-2422 Email lcostantini@vetlearn.com | Fax 201-231-6373 502 AUGUST 2008 | Veterinary Technician
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ClassifiedAdvertising TECHNICIANS WANTED
Your Talent. Our Team. As the nation’s largest network of veterinary hospitals and clinical laboratories, we know our support staff and professionals are critical to our success. That’s why we offer competitive salaries and generous benefits including: • Medical, dental and vision insurance • 401(k) retirement plan • Generous discount for personal pet care • Continuing education opportunities • Transfer opportunities and relocation • Exciting career advancement opportunities and specialty tech positions • Flexible scheduling These are just a few of the reasons why some of the nation’s top veterinary professionals consider joining VCA Animal Hospitals to be their smartest career move yet. Of course, working in one of VCA’s state-of-the-art facilities also has its advantages! Join us in one of our specialty hospitals and multi-doctor progressive practices. Come share your talent with our team and be a part of our family of over 1,800 doctors and 200 boardcertified specialists. We offer positions in 39 states and have more than 450 locations across the United States. Please visit us at www.vcapets.com. And feel free to contact us at (800) 216-8699 or talent@vcamail.com.
Place Your Ad Where It Will Get Noticed: www.VetClassifieds.com
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TECHNICIANS WANTED
NATIONAL Eye Care for Animals is a growing company dedicated to providing the finest in veterinary ophthalmology services. Our staff of board-certified ophthalmologists and clinical specialists provides the highest level of care, education, and understanding to our clients, their pets, and our referring veterinarians. With practices conveniently located in Arizona, California, Illinois, Kansas, Maryland, Nevada, New Mexico, Ohio, Texas, Utah, and Virginia, our ophthalmology services treat more than 25,000 patients a year. In addition, we provide consultation services to local zoos and various wildlife rehabilitation groups. We actively recruit for veterinary technicians, technician assistants, and client care representatives. As a pay-for-performance company, employees advance at their own pace through annual skill testing. We offer competitive pay and benefits, including: • Vacation/Sick/Holiday Pay • Tuition Reimbursement/Continuing Education • Medical/Dental/Life/Short- & Long-Term Disability Insurance • Potential Quarterly Gain-Sharing Bonuses • Relocation Stipend • Professional Membership Reimbursements • Travel Opportunities • Employee Recognition • Discounted Veterinary Services • Retirement Plan To learn more about our eye-opening career opportunities, please visit our website at www.eyecareforanimals.com.
ALABAMA – The Auburn University Critical Care Program is a busy, high quality Emergency/Critical Care facility at a teaching hospital, and is seeking candidates to fill several Small Animal Technician positions to care for critically ill animals. Various shifts are available, including day, night, weekend, and overnights. Applicants with advanced technical abilities, good communication skills, and a positive attitude are encouraged to apply. Opportunities for growth abound, with pursuit of VTS certification desired. Expand your skills working with ACVECC diplomats and residents in a state of the art facility with a challenging caseload! Excellent benefits package and shift differential available. Please direct inquiries to Dr. Jim Wohl: wohljam@auburn.edu; Dr. Dougie Macintire: macindk@auburn.edu; or Dr. Linda Martin: lgm0004@auburn.edu. For further information regarding the duties and responsibilities, minimum requirements, and application process, please apply online at www.auemployment.com and refer to Requisition #22674. Review of applications will begin June 20, 2008 and continue until candidates are recommended for appointment. AA/EOE
TECHNICIANS WANTED ALABAMA – Hampton Cove Animal Hospital is seeking a motivated LVT to join the team. Our progressive small animal hospital is looking for an outgoing team player with excellent people skills to provide quality care for clients and patients. Great attitude, strong work ethic, and attention to detail required. Our goal is thorough medicine, compassionate care, and excellent service. Competitive salary, commensurate with experience. Compensation package includes paid vacation, insurance, 401(k), and CE allowance. Please email or fax resume and references to Jaclyn@covepets.com or 256-533-7317. ALASKA – Experienced technician (license optional) needed for busy 24-hour emergency hospital. Sightsee in beautiful Alaska on your days off! Competitive wages, health and dental insurance, paid vacation, and CE opportunities. Send resume to PET Emergency Treatment, 2320 East Dowling Road, Anchorage, AK 99507; or fax 907-274-5133. Visit www.petemergencytreatment.com. ALASKA – Full-time CVT needed at Big Lake-Susitna Veterinary Hospital, LLC, located 50 miles north of Anchorage in Big Lake. High-quality, two-doctor AAHA-accredited practice with fully computerized medical records. Canine/feline only. Earn $16–$18/hr plus benefits. Minimum 3 years’ experience as licensed technician and computer skills required. High degree of technician responsibility; proficient skills and strong knowledge base expected. Send resume: email healthypets@blsvh.net; fax 907-892-9293; or mail 7362 West Parks Highway #793, Wasilla, AK 99654.
ARIZONA
Technicians Wanted Two career-oriented, full-time technicians needed for outstanding emergency and specialty hospital located in Tucson. Excellent benefits include health/dental, CE allowance, and paid time off. Fun-loving, friendly work environment with lots of Tucson sunshine!! To apply, download an application at www.southernazvets.com; email your resume to hr@southernazvets.com; or mail your resume to HR, 141 East Fort Lowell Road Tucson, AZ 85705.
CALIFORNIA – Fast-paced, four-doctor small animal clinic located on the central California coast in beautiful San Luis Obispo is seeking exceptional people to join our team. Must have excellent communication skills, be flexible, and enjoy a challenging environment with high client expectations! Full-time shifts may vary from 7AM to 8PM, including weekends. Send resume and cover letter to Animal Care Clinic, 162 Cross Street, San Luis Obispo, CA 93401; or fax 805-545-8497.
CALIFORNIA – Our two-doctor feline-only clinic seeks a part-/full-time technician. Fun, friendly, positive learning environment with modern surgical and diagnostic equipment. Must be a motivated team player with good communication skills and a positive attitude. Please fax resume to 916-447-1690 or email rc3pm@aol.com.
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Reach over 18,600 total qualified subscribers* with your ad in Veterinary Technician classifieds. We offer discounts for multiple ad placements, whether in one journal or across our line of publications—Compendium, Compendium Equine, Veterinary Technician, Veterinary Forum, and Product Forum and Market News. *Source: December 2007 BPA Statement
TECHNICIANS WANTED
TECHNICIANS WANTED
TECHNICIANS WANTED
CALIFORNIA – Excellent career opportunities for compassionate, skilled veterinary technicians in our state-of-theart, AAHA-accredited, multispecialty referral hospital. We are currently seeking experienced critical care/emergency and surgical technicians to join our team. RVT/VTS and anesthesia experience a plus. Salary commensurate with experience. Benefits include health insurance, CE, 401(k). Contact Mary Rattray at 818-244-7977. Send resume to Animal Specialty Group, 4641 Colorado Blvd., Los Angeles, CA 90039; email asgvets@asgvets.com; fax 818-507-9418; website: www.asgvets.com.
COLORADO – Our brand-new, progressive small animal emergency/critical care facility in Basalt needs two fulltime veterinary technicians to work rotating overnight and day shifts. Open positions are in emergency/critical care and surgery support/anesthesia. Previous experience is required. We are a small, multi-practice facility open 24/7. Our staff includes one board-certified and one board-eligible criticalist; a cardiologist; an ophthalmologist; a behaviorist; an acupuncturist; and two staff veterinarians. Great benefits! Interested candidates, please contact our lead technician Renee Gerlock, CVT: call 970-618-2833, or email rgerlock@valleyervet.com.
CONNECTICUT – Seeking highly motivated, experienced veterinary technician to join our progressive, busy, three-doctor hospital in Woodbury. Certification/ license preferred. Candidate will practice a full range of technician duties in our well-equipped, state-of-the-art hospital. Competitive salary and excellent benefits. Fullor part-time position available. Please contact Davis Companion Animal Hospital: call 203-263-8866, or fax resume to 203-263-6227.
CALIFORNIA – RVTs needed for busy AAHA-accredited emergency clinic with locations in Garden Grove and La Habra. Excellent opportunity to use and expand your technical skills! We have digital x-ray, ultrasound, endoscopy, and a full in-house lab. Must be available nights, weekends, and holidays. License required; recently registered technicians welcome. We offer medical/dental insurance, vacation, and uniform allowance. NO calls — email/fax inquiries and resume only: emyers@er4yourpet.com or 714-539-0815. CALIFORNIA – Busy 24-hour emergency referral hospital seeks qualified part-/full-time technicians; minimum three years’ experience required. We offer health insurance, 401(k), uniforms, and CE; 4-day/10-hour workweek. Salary commensurate with experience. Email Earl Abram II at eabram@aercvet.com, or fax resume to 310-257-0900.
COLORADO – The Veterinary Specialty Center in Colorado Springs is seeking an experienced part-/full-time CVT to join the internal medicine department. Our hospital is equipped with a full in-house laboratory, ultrasound, digital radio graphy, endoscopy, and advanced monitoring capabilities. We use a team approach and have a dedicated staff for critical care and chemotherapy. Please fax resume to 719-528-5368 or email to rdufort@veterinaryspecialty.com.
COLORADO – Busy mountain practice in gorgeous Gunnison seeks full-time certified or experienced veterinary technician. Applicant should be skilled in anesthesia, nursing, radiology, lab work, dental care, and venipuncture. Work with our board-certified internal medicine specialist and a local orthopedic surgeon. We have a complete in-house lab, state-of-the-art anesthesia equipment, ultrasound, fiber optics, x-ray and dental x-ray, EKG, and a blood pressure unit. We emphasize individualized patient care. Compensation is commensurate with experience. Benefits include CE, uniform allowance, pet care discounts, health insurance stipend, and matching IRA. Gunnison is located in the Rocky Mountains and provides a wealth of outdoor recreational activities. Please contact Dr. Steffanie Jacobson, DVM, DACVIM: call 970-641-2460; fax 970-641-0817; email rockymountainvet@yahoo.com. CONNECTICUT – Five-doctor, veterinarian-owned, AAHA-accredited hospital in Norwalk needs a technician. Work in a fun environment that promotes teamwork and personal growth. Great salary and benefits, including continuing education at national meetings. Contact Dr. Michele Lamothe at 203-846-3495 or email brah@aol.com. Visit us at www.broadriveranimalhospital.com.
Classified Advertising LIESE DIXON Phone 800-920-1695 or 267-685-2491 • Fax 201-231-6373 Email VetTechClassifieds@vetlearn.com Market Showcase Display Advertising LINDA COSTANTINI Phone 800-426-9119, ext 52422, or 267-685-2422 Fax 201-231-6373 • Email lcostantini@vetlearn.com 504 AUGUST 2008 | Veterinary Technician
CONNECTICUT – Busy six-doctor small animal practice in Norwalk seeks compassionate full- or part-time technician skilled in anesthesia monitoring, dentistry, radiology, laboratory work, and nursing care. Practice offers full surgical schedule, grooming services, large boarding facility, and separate cat-only hospital. Benefits available. Phone: 203-8475875; fax: 203-849-3015; email: strawberryh@snet.net. FLORIDA – Emergency Pet Care LLC, an off-hours small animal emergency hospital located in Jacksonville, is seeking a dedicated, passionate CVT to be our head treatment nurse. Responsibilities include: nursing duties, patient advocacy, inventory and equipment management, staff education, client management, and basic managerial responsibilities. We have a variety of “toys” to work with, including: digital x-ray, ultrasound, Doppler blood pressure, vital scan monitor, full in-house blood machines, endoscope, fluid/syringe infusion pumps, VetEd tablets, and Avimark software. Our doctors are always willing to share knowledge and CE is available and encouraged. Candidates for this full-time, salaried position must possess excellent communication skills, a professional work ethic, and a minimum of 4 years’ technical experience. We offer a generous benefit package, including CE, health benefits, and a flexible schedule in a thriving beach community. Nights, holidays, and weekend hours required. Mail resume, Attn: Office Manager, to 14185-7 Beach Blvd., Jacksonville, FL 32250.
To place your classified or Market Showcase ad, contact us today! www.VetTechJournal.com
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Veterinary Technicians/Nurses We are a state-of-the-art small animal referral practice located in West Palm Beach. Our in-house veterinarians and consultants specialize in emergency and critical care, surgery, internal medicine, oncology, neurology, cardiology, radiology, and behavior sciences. We have a place for you, whatever your interests may be! Qualities required in our technicians and nurses include:
Coral Springs Animal Hospital—a primary care/multispecialty/critical care/emergency facility, open 24 hours/day—is always accepting applications for enthusiastic, motivated, compassionate, dedicated, quality-minded AHTs and CVTs or similarly experienced technicians without a degree. New graduates are encouraged to apply. We practice professional, excellent veterinary medicine and surgery with the highest degree of ethics and integrity. We are looking for individuals who want to use their veterinary nursing technical skills to the fullest. Technicians with the desire to work at a premium facility that has a great record of retaining excellent veterinary nurses are encouraged to apply. Salary is commensurate with experience but will range from $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, discounted pet care. Drug-free workplace. Four-day workweek. Please visit our website at www.coralspringsanimalhosp.com. Please send resume to: Coral Springs Animal Hospital 1730 University Drive Coral Springs, FL 33071 Attn: Megan Kelly, Nurse Manager Phone 954-753-1800; Fax 954-343-0238
FLORIDA – Veterinary hospital in Palm Coast is seeking a full-time, experienced technician to join our team. Florida state licensure is preferred, but applicants with hands-on experience in a small animal hospital will be considered. Candidate must demonstrate proficiency in all skills necessary for basic patient care, anesthesia, radiography, and surgical assistance, such as placing IV catheters, anesthesia and intubation, venipuncture, surgical preparation and monitoring, restraint, assessment and triage, radiograph techniques, dental prophylaxis, client education, and general care of companion animals. Competitive salary and benefits for the right person. Qualified applicants please contact: Lynn Williams Safe Haven Veterinary Hospital 30 Lupi Court, Palm Coast, FL 32137 Email: LWilliams@safehavenvet.com Fax: 386-446-8317
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• 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 Referral & Critical Care Center: 561-434-5700; and/or send your resume, Attn: Jennifer: Fax: 561-296-2888 • Email: pbvrs@earthlink.net.
GEORGIA – Veterinary technician needed for small animal practice in coastal Georgia. Benefits package includes insurance, 401(k), PTO, and CE allowance. Please contact Dr. Shireen Hamid: call 912-571-0040 or email thecritterdoc@hotmail.com.
FLORIDA – MIAMI VETERINARY SPECIALISTS is a state-of-the-art veterinary referral practice with multiple board-certified specialists on site. MVS practices high-quality, cutting-edge veterinary medicine. MVS is looking for highly enthusiastic, self-motivated, experienced team players to join our fast-growing technician staff. Work to your fullest capability with our specialists assisting in: Ultrasonography • Endoscopy • Oncologic surgery • Neurologic surgery • Dermatology • Fluoroscopy • Orthopedic surgery • Soft tissue surgery • Internal medicine • 24-hour emergency care • And much more Specialized duties include: patient monitoring (including anesthesia), ICU and critical care, surgical prep, sterility assistance, specialized diagnostics and treatments, radiography, and the ability to think and handle responsibility. Benefits include: 401(k), CE, paid vacation, medical/dental insurance, pet discounts, and more. New graduates welcome. Interested veterinary technicians, please apply in person: Miami Veterinary Specialists 8601 Sunset Drive, Miami, FL 33143 or fax resume to 305-665-2821, Attn: Brad, or call 305-665-2820 for more information. www.mvshospital.com
FLORIDA – Veterinary technician needed for small animal
practice in Tallahassee. Located in a great university community close to the Gulf Coast. Salary and benefits for fulltime. Contact Dr. Carter for an application and interview: 850-878-4799.
ILLINOIS – Veterinary Specialty Center is a state-of-the-art multidisciplinary specialty referral hospital located in the northern suburbs of Chicago. There are great opportunities for certified technicians and veterinary assistants to join our team. Our growing specialties include surgery, internal medicine, oncology, cardiology, nephrology, neurology, radiology/imaging, emergency and critical care, dermatology, physical therapy, behavior, and ophthalmology. We have an excellent work environment with outstanding compensation and benefits. For more information on these exciting and challenging opportunities, please contact: Evelyn Feekin Veterinary Specialty Center 1515 Busch Parkway, Buffalo Grove, IL 60089 Fax 847-459-1848 • Phone 847-459-7535 x312 or email at efeekin@vetspecialty.com.
ILLINOIS
Full-Time CVT Wanted Village Veterinary Practice is seeking a skilled and energetic full-time CVT to join our friendly team. We are a constantly growing, fast-paced small animal clinic located in a western suburb of Chicago. We seek a hardworking, self-motivated, and compassionate individual interested in helping us provide the highest quality of care for our patients and clients. Your skills will be fully utilized in our full-service hospital, where we always encourage professional growth. We offer competitive wages, paid vacation, health insurance, retirement plan, CE, pet discounts, and much more! To learn more about us, visit our website: www.villageveterinary.com. Please send resume to Erica Meccia, CVT: fax 708-246-9114, or email emeccia@villageveterinary.com.
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The next available issue is ILLINOIS EXPERIENCED TECHNICIANS and CVTs WANTED Are you a professional? We have full-time positions open for CVTs or experienced emergency and critical care technicians to become members of our team. Our hospital is a 24-hour emergency and treatment center that features specialty surgery, critical care, and internal medicine. Our team of veterinarians and technicians is here because they believe that emergency and critical care offers the opportunity to practice the highest level of veterinary medicine. Sound challenging? We think so! We are looking for technicians who have the desire to learn and want to expand their knowledge and acquire new skills in these specialty fields. We offer a competitive salary and complete benefits package.
ILLINOIS – State-of-the-art emergency practice in the heart of Chicago is seeking talented veterinary technicians to join our team of compassionate, care-oriented, adrenaline-fueled supertechs. There’s never a dull moment at Chicago’s only after-hours emergency service, open nights, weekends and holidays. Enjoy all that Chicago has to offer by day; practice by night. We offer a flexible schedule, competitive salary, comprehensive benefits package, and an environment focused on patient care. Contact Alice Murtas, Chicago Veterinary Emergency Services 3123 North Clybourn Avenue, Chicago, IL 60618 Phone: 773-281-7110; Fax: 773-281-7928 Email: alice@chicagoveterinaryemergency.com.
OCTOBER
which closes
AUGUST 29 For information about ad placement, call Liese Dixon at 800-920-1695.
Interested candidates, please contact Cathie Moses at 847-548-5300 or fax your resume to 224-656-5180. Email: sshogren@aetcenter.com.
ILLINOIS Seeking a fulfilling and challenging career? Join Animal Emergency & Referral Center, one of the area’s fastest-growing veterinary centers, located in Chicago’s northern suburbs. AERC is a 24-hour emergency/critical care and specialty referral hospital, where board-certified specialists head each referral discipline: cardiology, imaging, internal medicine, neurology/neurosurgery, and orthopedic/soft tissue surgery. We seek experienced, energetic, skilled technicians to support our emergency/ICU and specialty departments. All of our talented and dedicated doctors and technical staff are committed to providing compassionate, progressive patient care and services 24/7. At AERC, we appreciate, encourage, and reward talent! We offer a competitive salary and benefits package, which includes health/dental/life insurance, uniform/CE allowances, 401(k), paid vacation/sick time, and no rotating shifts. Fax Sheri at 847-564-9604. Email srothschild@AERCenter.com. Visit us at www.aercenter.com.
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.
INDIANA – RVT wanted for progressive, fast-paced, the-art facility. We offer a competitive salary and a commulti-doctor small animal practice in Hobart. Must be a motivated self-starter and team player with proficiency in technical and client relation skills. Competitive salary and benefits. Fax cover letter and resume to 219-942-6933, Attn: Brian Thompson; or email hobartanimalclinic_BET@ comcast.net
ILLINOIS – Twenty-four–hour referral hospital near LOUISIANA – Specialty and emergency veterinary hosChicago seeks technician to assist medical oncologist. Must be CVT or have 3+ years’ experience. Proficiency in drawing blood, patient restraint, and placing catheters required. Also accepting applications for a certified/experienced technician to assist internal medicine specialist — position opening fall of 2008. We offer a competitive salary/benefits package, including 401(k), company-sponsored CE, health insurance, paid vacation, and much more! Please email resume to mary.burke@vcamail.com, or fax 708-749-1716.
506 AUGUST 2008 | Veterinary Technician
pital seeks experienced technicians. We are a fully equipped 24-hour facility specializing in surgery, internal medicine, and oncology. We also offer physical rehabilitation and after-hours emergency and critical care. We are looking for motivated individuals who enjoy working in a fast-paced, team-driven atmosphere and who are dedicated to providing the highest standard of care. Our practice is located just 40 minutes from historic downtown New Orleans and the French Quarter. Come utilize your skills and expand your knowledge at our state-of-
prehensive benefits package, including health, dental, and 401(k). Interested candidates: call Shelly Spotswood at 985-626-4862 or fax resume to 985-626-4852. Visit our website at www.lavrc.com.
MARYLAND – Experienced veterinary technician needed for progressive, high-quality, state-of-the-art referral and emergency center. Located on 30 acres in Frederick. Great salary and working conditions. Fax resume and cover letter to 301-874-8880 or email jfinnegan@greenbriarpethospital.com. Visit our website at www.greenbriarpethospital.com.
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MARYLAND – Our team-oriented, high-tech small ani- MASSACHUSETTS – The School of Animal Science mal hospital seeks a competent veterinary technician. Great pay and benefits. Send your resume/inquires to Dr. Esra Yavuz: Animal Medical Center, 142B North Bond Street, Bel Air, MD 21014; email esra@doctoresra.com; or fax 410-420-9175.
Veterinary Emergency & Specialty Center of New England
MASSACHUSETTS We are hiring qualified veterinary technicians and client liaisons for the following departments: • Emergency/Critical Care • Surgery • Radiology Sign-on bonuses for new full-time employees; competitive salaries; excellent CE package; generous paid vacation; and much more! Contact Jaime Coughlin, CVT (ECC), Director of Nursing: Phone: 781-684-8387; Fax: 781-890-2871 JCoughlin@vescone.com. Visit us at www.vescone.com.
MASSACHUSETTS
Come join the Tufts team on our beautiful Grafton campus! Put your skills to work in our state of the art teaching hospitals where certification, education and experience are rewarded. Challenge yourself to excel in an environment that values Veterinary Technicians as essential team members.
VETERINARY TECHNICIANS • Small Animal Emergency and Critical care • Small Animal Medicine • Large Animal Medicine • Neurology • Anesthesia • Animal Care Attendants • Pharmacy opportunities Competitive salary and outstanding benefits package. Apply online or call the Human Resources Office for more information. Tufts University is an AA/EO employer and actively seeks candidates from diverse backgrounds.
Cummings School of Veterinary Medicine at Tufts University. (508) 839-7975 www.VetTechJournal.com
www.tufts.edu
seeks applicants for a full-time faculty position in the Veterinary Technology Program at the assistant/associate professor level, beginning in the 2008–2009 academic year. Candidate must be a graduate of an AVMA-accredited veterinary technology program or college of veterinary medicine. An advanced degree (Masters, PhD, or DVM) in an appropriate discipline is required; a doctorate and previous teaching experience are preferred. The faculty member will teach assorted courses within the veterinary technology program, such as Veterinary Clinical Laboratory, Veterinary Pathology, Veterinary Microbiology, and Veterinary Radiography. To assure full consideration, qualified applicants are encouraged to forward a cover letter, resume, and at least three professional references to: Human Resources Office, Mount Ida College, 777 Dedham Street, Newton, MA 02459; email: jobs@mountida.edu; fax: 617-928-4002. Mount Ida College is an equal opportunity employer. Applications from individuals who will increase the richness of the college’s diversity are welcomed.
MASSACHUSETTS – Seeking experienced full-time veterinary technician to join our small community-oriented small animal/pocket pets practice. Must have excellent communication skills and enjoy working with the public. Health insurance, retirement plan, CE/uniform allowance, and generous vacation, personal, and sick time. No weekend, holiday, after-hours emergency, or night hours. Please send resume and cover letter to: Dr. J. Harrison, c/o Middlesex Animal Hospital, 668 Main Street, Reading, MA 01867; or fax 781-942-1313.
MICHIGAN – Small animal emergency/referral hospital in Kalamazoo is in need of another LVT. Board-certified surgeon and emergency/critical care specialist on staff. LVT duties will include anesthesia, surgical assistance, intensive care nursing, radiology, and clinical laboratory work. Full-time position with excellent salary and benefits. Send resume to Southwest Michigan Animal Emergency/Referral Hospital, 6039 South Westnedge Avenue, Portage, MI 49002; fax to 269-323-3636; or phone 269760-4056.
NEVADA The Las Vegas Veterinary Referral Center is a state-of-the-art, 13,000–sq. ft. multispecialty hospital located in the prestigious southwestern area of Las Vegas and is the only multispecialty hospital in southern Nevada. Our doctors are board-certified specialists in surgery, internal medicine, oncology, neurology, and cardiology, with more specialties anticipated within the next year. Our current and projected growth and unique positioning within the local veterinary market provide tremendous career opportunities. We seek skilled licensed or certified technicians and technician assistants who are team players and effective communicators. Candidates qualified to join the LVVRC team must have clinical and interpersonal skills and a desire to assist in case management. New graduates welcome! Highly competitive pay, benefits, flexible shifts, and a great work environment. Please send your resume, Attn: Hospital Administrator, to Las Vegas Veterinary Referral Center: fax 702-262-7000, or email jobs@lvvrc.com; www.lvvrc.com.
TECHNICIANS WANTED NEW JERSEY – RVT needed for busy, two-doctor, AAHA-accredited small animal practice in beautiful Sussex County. Must be a motivated self-starter and team player with proficiency in technical and client relation skills. Competitive salary; benefits include vacation/personal time, health insurance, uniforms, CE, 401(k). Fax cover letter and resume to 973-729-4092, Attn: Diane; or email dvanlear59@yahoo.com. NEW JERSEY – Full- or part-time technician needed for six-doctor practice in Morris Plains. We are a small animal/exotics practice with our own on-site ultrasound, chemotherapy, endoscopy. Duties include outpatient client communication, surgery, anesthesia monitoring, hospital treatments, and general nursing care. Includes some weekend/evening hours. Salary commensurate with experience. Send resume, Attn: Peggy, to Community Animal Hospital, 921 Route 53, Morris Plains, NJ 07950; email communityah@ optonline.net; or fax 973-984-1855. Phone: 973-267-4220. NEW YORK – Licensed veterinary technician wanted for Rhinebeck Animal Hospital, located in the Hudson Valley. We are a progressive, fast-paced, seven-doctor pet hospital that cares for dogs and cats. New facility with advanced dental and anesthetic monitoring equipment. Tom: 845-876-6008; tom@rhinebeckanimalhospital.com. NEW YORK – Licensed or license-eligible technician needed at six-veterinarian, AAHA-accredited, 24/7 full-service hospital on the Upper East Side. Digital x-ray, ultrasound, VetScan, endoscope, laser surgery, and excellent technical support. Appointments 7 days/week. Competitive pay and benefits; flexible schedules. See website: www.parkeastanimalhospital.com. Fax or email resume: 212-355-3620; parkeast@aol.com.
NEW YORK – The Veterinary Technology Department at Medaille College seeks a full-time 10-month technician. Duties will include assisting in various laboratories — which requires strong skills in small animal nursing and surgical assistance and the ability to work with laboratory animals and exotics; student advisement; sharing supervision of animal housing facilities; and mentoring student activities. Must possess NYS license or be license-eligible. Three years’ experience in clinical and other settings preferred. Communication skills and the ability to work cooperatively in a team atmosphere are important. Medaille is a growing, private, four-year liberal-arts–based college in Buffalo that serves the educational needs of traditional and non-traditional students in western New York and southern Ontario through a variety of undergraduate and graduate programs. Please submit resume with cover letter and three contact references to Barbara Bilotta, Director of Human Resources, Medaille College, 18 Agassiz Circle, Buffalo, NY 14214. Review of applications will continue until position is filled. No phone calls, please. www.medaille.edu. AA/EOE.
NEW YORK – Full-time licensed or license-eligible veterinary technician wanted for cat hospital in Queens, NYC. Responsibilities include lab work, radiology, nursing care, surgery, and dentistry. New graduates welcome; experience preferred. Call Dr. Luger, Liz, or Kelly at 718-416-2282; or fax resume: 718-416-8035. NORTH CAROLINA – Full-time RVT or experienced veterinary technician needed for three-doctor practice in Winston-Salem. Proficiency in dentistry, radiology, lab work, anesthesia, and nursing care is required. Must be a team player with good people skills. Fax resume to 336-765-2789.
NORTH CAROLINA Full-time RVT wanted for family-oriented five-doctor animal hospital in Charlotte. Competitive salary and excellent benefits. Fax resume to 704-369-0789 email dpmanager@mallardcreekvet.com or call 704-598-6525.
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NORTH CAROLINA North Carolina State University’s College of Veterinary Medicine is growing! The 110,000–sq. ft. Randall B. Terry Jr. Companion Animal Medical Center is scheduled to open in winter 2009. We are currently recruiting for the following positions: • Large Animal Hospital Manager, #100180 • Small Animal Emergency Clinic Veterinary Technicians, #62047 / #65350 • Small Animal ICU Technicians • Surgery Technician, #44046 • Veterinary Technicians, #RVT-0708 • Veterinary Attendants, #VA-0708 Please visit jobs.ncsu.edu for details about numbered positions and to apply online. Alternatively, you may fax resume and cover letter to Jim Brawley at 919-513-6225. Full position listing available at www.cvm.ncsu.edu/vth/employment.php. NCSU is an equal opportunity/affirmative action employer and welcomes all persons without regard to sexual orientation. ADA contact: 919-515-3148
OHIO
Registered Veterinary Technicians Needed Metropolitan Veterinary Hospital is in need of registered veterinary technicians to assist with our high-volume, state-of-the-art central hospital and referral center. We offer a wide range of services: internal medicine, surgery, neurology, ophthalmology, cardiology, and emergency and critical care. Primary responsibilities would include assisting with animal care, basic laboratory duties, diagnostic techniques, and surgical procedures, with a secondary function involving client contact, reception skills, and personal technical development. Candidates must be RVTs licensed in Ohio with a proven ability to function in a fast-paced environment. New and experienced technicians welcome.
TECHNICIANS WANTED OHIO – Full-time RVT needed for medical oncology department at MedVet Medical Center for Pets — a large, multispecialty veterinary medical center in Worthington. Great leadership and communication skills required. We also seek full- and part-time RVTs for the ER for various shifts and openings. Excellent pay and benefits plus shift differential for 2nd, 3rd, and weekend shifts. Sign-on bonuses available for successful hires; commensurate with experience. Email resumes to employment@medvetohio.com; or fax, Attn: Human Resources, to 614-431-4419. PENNSYLVANIA – Experienced full-time technician needed at Hamilton Animal Care, a five-doctor small animal and exotics practice located near Allentown in Wescosville. Duties include surgery, dentistry, radiology, medical care, in-house laboratory work, and client services. Salary commensurate with experience. Benefits include medical, 401(k), uniform allowance, holiday/vacation pay, and CE. Interested applicants, please fax resume to 610-395-2346, Attn: Jacky or Barbara. PENNSYLVANIA – Certified technician wanted for busy small animal house-call practice in Pittsburgh. We are now in our fifth year of business serving Pittsburgh and the surrounding suburbs. We seek an experienced, clientoriented person to work with the doctor and handle calls independently. Part- and full-time positions available. Please contact Jill at 412-496-7779, or email resume to info@vetopet.com.
PENNSYLVANIA Certified veterinary technician wanted to join our team. Exeter Veterinary Hospital is a four-veterinarian, progressive, computerized, AAHA-accredited companion animal hospital east of Reading. Duties include, but are not limited to, in-house laboratory, radiology, surgery, dentistry, and client services. We are a well-equipped facility including an ultrasound, laser, endoscope, and complete dental room. Benefits package includes a retirement plan; uniform allowance; holiday, sick, and vacation pay; as well as continuing education. If interested, please contact Jenessa, staff manager, or Richard Rosato, hospital manager, at 610-779-2300 or fax resume to 610-779-3166.
508 AUGUST 2008 | Veterinary Technician
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.
PENNSYLVANIA – Immediate CVT position at progressive three-doctor small animal practice in Chester County. Job requires work in all areas of the hospital with duties including but not limited to: radiography, general and surgical nursing, anesthesia, dentistry, lab services, exotic medicine, inpatient (hospital ward) care, outpatient (well-pet) care, and reception duties. We offer flexible hours and competitive wages. Benefits: holiday/vacation pay, sick/personal days, SIMPLE IRA, CE, miscellaneous fund, pet care discount, uniform allowance; CVT license fee paid. Send resume/references to Animal Clinic at Thorndale: 431 Bondsville Road, Downingtown, PA 19335; fax 610-873-1827; or email animalclinicatthorndale@ verizon.net. Phone: 610-873-4091.
PENNSYLVANIA – Progressive, growing small animal hospital and referral center in northeastern Pennsylvania seeks highly motivated, responsible, full-time veterinary technician. Must be a friendly team player who is willing to work in a fast-paced environment. License and experience preferred; candidates with related experience or education will be considered. Your skills will be fully utilized to provide superior patient care. Health and dental benefits, paid vacation, competitive salary, no holiday work. Contact Barbara at 570-675-3406 or email resume to backmtvethosp@yahoo.com.
SOUTH CAROLINA – Seeking proficient, self-moti-
We offer competitive wages, health benefits, uniforms, paid time off, and a rewarding work environment. If you are interested in joining our team, please send your resume to: Metropolitan Veterinary Hospital, Attn: Human Resources 1053 South Cleveland-Massillon Road Akron, OH 44321; Fax 330-666-0519; or email to s.steen@metropolitanvet.com (subject: Registered Veterinary Technician).
TECHNICIANS WANTED
LOOK NO FURTHER.
We’ve got your ideal job!
vated technician with a strong knowledge of veterinary nursing. Must be able to multitask and dedicated to providing the highest level of care in a busy emergency practice. We are willing to teach specific tasks to a candidate with an established knowledge base. Our highly trained staff provides the finest care in our state-of-theart, AAHA-accredited hospital, which is part of the South Carolina Veterinary Referral complex. Full-time position with a competitive salary and benefits package that includes 100% paid health insurance, 401(k), CE allowance, vacation time, paid holidays, night differential, uniforms, significant pet benefits, longevity pay, sign-on bonus, and optional moving assistance. Send resume to Gretchen Dillon-Sauer, CVPM: fax 803-798-8793 or email gsauerscvec@yahoo.com.
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TENNESSEE – We are growing again and have openings for two licensed or license-eligible veterinary technicians. Pet Emergency Treatment Service offers after-hours emergency care for dogs and cats in the Brentwood/Franklin area. We have one part-time and three full-time emergency doctors, six full-time LVTs, and other great support staff. We are next door to an established daytime surgery specialty practice. Excellent pay and benefits for the right candidate. Rotating schedule has large blocks of time off. Email your resume and inquiry to PETSEmergency@aol.com or call 615-554-7387.
TECHNICIANS WANTED
TEXAS
VIRGINIA
$1,000 Sign-On Bonus
Interested in joining one of the largest progressive emergency veterinary clinics on the peninsula?
TEXAS
We are seeking experienced technicians and RVTs for our progressive, after-hours emergency hospital located in North Houston. Practice in a new, state-of-the-art facility with the highest standards of patient care. We offer a great work environment, an excellent salary/benefits package, uniforms, CE, flexible schedules, and a terrific support staff. This is veterinary emergency medicine at its best! $1,000 SIGN-ON BONUS!
Veterinary Technician
Send resume to hr@aeucc.com.
The University of Texas Medical Branch at Galveston needs a full-time (40 hours/week) veterinary technician to provide technical expertise in all aspects of anesthesia; aseptic surgery support; pre- and postoperative care; and clinical and laboratory support services.
TEXAS – The Animal Emergency Center of West Houston, the
Responsibilities will include administering treatments as directed by supervisors; anesthesia induction, maintenance and monitoring; surgical/veterinary record-keeping; operation, set-up, and maintenance of surgical equipment and the operating suite; radiograph exposure and development; sample collection and processing; and participating in daily rounds and health checks. High school diploma or equivalent plus 2 years of related experience required. AALAS certification (ALAT level), RVT, or equivalent preferred. Interested candidates should apply online at www.utmb.edu/hcm (Job Title: Veterinary Technician). UTMB at Galveston is an equal opportunity, affirmative action institution that proudly values diversity. Candidates of all backgrounds are encouraged to apply.
fastest growing AAHA-accredited emergency center in the country, is currently looking to hire a fourth associate for our state-of-the-art facility. Candidates should be willing to work nights, weekends, and holidays. We offer very competitive wages (to be determined with experience) and benefits (health insurance, vacation, sick time, CE, license fees, uniform allowance, etc.). Interested candidates can email their resumes to aecwh.aecwh@hotoffice.net or fax to 832-593-8388.
UTAH – We are seeking skilled veterinary technicians with a perfect mix of technical and client service capabilities for a highenergy 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 teambased 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
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The Emergency Veterinary Clinic — part of the Peninsula Veterinary Associates’ comprehensive veterinary network — is seeking compassionate, team-oriented, positive, experienced full-time LVTs that have strong communication skills, an energetic attitude, and empathy and enthusiasm for assisting client and patient alike. We offer competitive salaries, 100% health insurance, 50% dental and life, SIMPLE IRA, CE, paid vacation, and sick leave. Part-time positions are also available. Our 12,000–sq. ft. emergency/referral center is located between historic Williamsburg and the Virginia Beach/Norfolk metropolitan area. The state-of-the-art facility’s amenities include extensive monitoring and diagnostic equipment and digital radiography. The EVC is located in a separate area of the referral center and has enjoyed strong support from area practices for 30 years. The Hampton Roads area offers recreational opportunities rich in colonial and military history. A short drive will also take you to a number of other popular destinations, including Washington, DC; the Outer Banks of North Carolina; Richmond; and the mountains of Virginia. To learn more about this exciting opportunity, please email your resume and cover letter to careers@peninsulavets.com or fax to 757-596-6060, Attn: EVC. Visit www.peninsulavets.com for more information about our facility, employment opportunities, and the PVA!
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Veterinary Technician | AUGUST 2008
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ClassifiedAdvertising TECHNICIANS WANTED
TECHNICIANS WANTED
VIRGINIA – Small animal practice
VIRGINIA
in Chesapeake seeking full-/part-time LVT. Technical skills fully utilized in modern, well-equipped facility. Caring, compassionate team player with organizational skills and experience desired. Excellent pay and benefits. Fax resume/references to Brentwood Veterinary Clinic at 757-485-1388 or email dpcleek@cox.net.
VIRGINIA – LVT needed at small animal practice 20 minutes west of Richmond. Friendly staff looking for motivated, organized new member with team-player mentality. Fulltime hours available; 5-day workweek, alternating weekends. Competitive benefits package. Send resume to Loretta: Goochland Animal Clinic, 2000 Maidens Road, Maidens, VA 23102.
VIRGINIA – We are looking for a full- or part-time LVT to join our growing AAHA-accredited practice. Our four-doctor/two-LVT small animal practice has great clients and a welltrained, highly committed staff and we need another eager LVT to grow with us. Duties include providing nursing care, taking radiographs, monitoring anesthesia, assisting in surgeries, collecting and processing laboratory specimens, and giving routine vaccines. We offer boarding and grooming services, so your knowledge and skills will be put to good use. We offer highly competitive benefits, including paid vacation, continuing education, and insurance. Salary commensurate with skills and experience. Please contact Sherry Meier, Office Manager; Ross W. Moore, DVM; or Toni Connell, DVM: Independent Hill Veterinary Clinic, 13444 Dumfries Road, Manassas, VA 20110; call 703-791-2083; or email kirby13444@aol.com. Calls preferred.
VIRGINIA
LVTs and Student Technicians The LifeCentre for Veterinary Emergency & Specialty Care in Leesburg has full-/part-time 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.
510 AUGUST 2008 | Veterinary Technician
LVT Wanted We are looking for a personable individual eager to utilize his/her technical skills at our busy, progressive, eight-doctor small animal hospital in Virginia Beach. Full-time position with excellent salary and benefits. Contact Dr. Alex DeLorenzo at 757-523-6100.
WASHINGTON Busy, five-doctor practice that primarily sees small animals seeks full- or part-time LVT. Competitive salary, paid vacation, sick leave, health benefits, retirement plan, and CE and uniform allowances offered. Our clinic includes a well-equipped surgery suite with laser; ultrasound; endoscope; new digital radiography; organized pharmacy; and fully equipped in-house lab. Wenatchee is a beautiful city that sees all four seasons. We are located by the Columbia River, which offers parks, trails, and boating. Our valley also provides hiking, mountain biking, and skiing opportunities. Send resume to Angie at Cascade Veterinary Clinic 1201 Walla Walla Avenue Wenatchee, WA 98801 fax 509-663-5966; or email cascadevet@cascadevetclinic.com. Phone: 509-663-0793; website: www.cascadevetclinic.com.
WASHINGTON – Want to see your knowledge and skills utilized to their full potential? Interested in pursuing a career in emergency and critical care or surgery? Alpine Animal Hospital is a large, AAHA-accredited hospital in Issaquah (just east of Seattle) that offers 24-hour emergency care and an excellent day practice. We have ultrasound, endoscopy, digital radiology, and an ACVECC specialist and need new, energetic team members. We seek motivated licensed or experienced ER technicians. We also need a graveyard shift ER LVT and an LVT for surgery. This is a great opportunity to utilize your skills in a learning environment and work with our specialist, who works weekends! The ideal candidates are self-motivated, compassionate, skilled, fun, and great team players! Benefits: signing bonus, CE compensation, M/D/V, matched 401(k), license dues, pet benefits, vacation/sick days, uniforms, competitive salary, and relocation assistance (where applicable). Email resume to Allison Perkins, LVT at allison.perkins@vcamail.com or fax 425-391-7439. WASHINGTON – Our well-equipped, five-veterinarian, AAHA-accredited facility in Lacey is hiring one or two fullor part-time LVTs. We are a fun-loving team that works to provide awesome patient care. Your skills will be fully utilized. Both new and experienced LVTs are welcome to apply. Contact Mayme Revel, Operations Manager: 360438-9623 or mtnviewvet@comcast.net. Check us out at www.mountainviewvet.com.
TECHNICIANS WANTED WASHINGTON – Fast-paced, six-doctor, AAHA-accredited hospital located in Seattle is looking for a responsible, enthusiastic, full-time LVT or experienced assistant with lots of initiative who is committed to high-quality animal care and superior client service in a team-oriented atmosphere. Benefits include health and dental insurance, 401(k), CE, uniforms, and more. Salary DOE. Contact David, technician supervisor: Elliott Bay Animal Hospital, 2042 15th Avenue West, Seattle, WA 98119; phone 206-285-7387; fax 206-285-9074; email dzajac@elliottbayah.com. Visit www.elliottbayah.com.
WISCONSIN – CVT position available for five-doctor practice. Use ALL of your skills with laser, ultrasound, laparoscopy, echocardiography, and more. Excellent pet benefits, vacation, CE allowance, health insurance. For more information, contact Melinda at 920-434-1010, or send resume to Animal Hospital of Howard, 635 Cardinal Lane, Green Bay, WI 54313.
MANAGERS/SUPERVISORS WANTED
NEW YORK – Monroe Veterinary Associates is hiring! Our system consists of 13 full-service veterinary hospitals, a 24-hour pet emergency facility, a specialty referral center, a house call service, a rehabilitation center, and an extensive reference laboratory — all located in and around scenic Rochester. Our support staff includes dedicated, compassionate animal care assistants and customer service representatives and a highly skilled group of certified technicians, including AVECCT- and AVTA-certified specialists. We are currently accepting applications for several open positions, including veterinary technician supervisor and LVTs. The veterinary technician supervisor will oversee the technical support staff on the overnight shift at Veterinary Specialists & Animal Emergency Services. This hospital consists of a high-volume, fast-paced referral practice with board-certified specialists in cardiology, ophthalmology, and surgery; and a 24/7 emergency service staffed with experienced, internship-trained emergency doctors. Qualified candidates must have 1–2 years’ supervisory experience and New York state licensure. LVT positions are available at Bayview Animal Hospital, Cats and Critters, and Veterinary Specialist & Animal Emergency Services. Qualified candidates have a 2- or 4-year veterinary technician degree and current or pending NYS licensure. Please send resume, Attn: Human Resources, to: Animal Hospital of Pittsford 2816 Monroe Avenue Rochester, NY 14618. We offer a competitive compensation package, including medical, dental, and 401(k). EOE. For all available employment opportunities and more information about us, please visit www.monroevets.com.
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C L A S S I F I E D S ORDER FORM Please Place My Ad In ®
The Complete Journal for the Veterinary Health Care Team
C O N T I N U I N G E D U C A T I O N F O R V E T E R I N A R I A N S TM
for ____________ issues
for ____________ issues
for ____________ issues
for ____________ issues
Pricing, Discounts, and Options Price per word (40-word minimum charge) $2.20
Single Ad Placement
Available Discounts* ❏ Single ad placed in multiple issues (e.g., one ad placed for 2 months in Veterinary Forum) ❏ Single ad placed in multiple journals (e.g., one ad placed for 1 month each in Veterinary Forum and Compendium) ❏ Single ad in multiple journals for multiple months (e.g., one ad placed for 2 months each in Veterinary Forum and Compendium)
10% off 15% off 20% off
Add-On Options ❏ Early Internet Exposure — Place your ad on VetClassifieds.com 30 days before your first issue release date. (one-time cost) $30 ❏ Instant Internet Exposure — Your ad appears on VetClassifieds.com up to 7 weeks before your first issue release date. (one-time cost) $45 ❏ Confidential Forwarding Service — Direct inquiries to our attention; we send them to you via mail and/or email. (one-time cost) $40 ❏ Deluxe Package — Add a box border and bold contact information. Choose from six styles (see below). $50 ❏ Premium Package — Deluxe package plus your logo (email as high-resolution tiff, jpeg, or eps file). $100 Deluxe/Premium Package Style Sample (circle letter) A B C
D
E
F
*First ad pays full price. Subsequent ads are eligible for one discount per ad, barring promotional specials. Percentage discounts are taken from total cost of ad.
Payment I will pay by (check one):
Check
Money Order
MasterCard
VISA
American Express
Call for details regarding check or money order payments.
Expiration Date ________ /_________
Credit Card Number
Cardholder Name ______________________________________________ Contact Name ____________________________________ Clinic/Company __________________________________________________________________________________________________ Address ________________________________________________________________________________________________________ City __________________________________________________________ State ____________ Zip _____________________________ Telephone (
) ______________________________________________ Fax (
) ______________________________________
Address_________________________________________________________________________________________________________ (credit card billing address if different from above)
Authorized Signature ______________________________________________________________________________________________ SPECIFICATIONS
ORDERING INFORMATION
• Counting Words: A new word is counted after every space. City, state, zip code, and phone/fax numbers are one word each. Email and Internet addresses are three words each.
Mail or fax order form and your ad to: Classified Advertising,Veterinary Learning Systems, 780 Township Line Road,Yardley, PA 19067 • Fax 201-231-6373 Email your ad and payment information to: VetForumClassifieds@vetlearn.com CompendiumClassifieds@vetlearn.com VetTechClassifieds@vetlearn.com CompendiumEquineClassifieds@vetlearn.com
• Payment: Include complete billing information with all orders. • Deadlines: No cancellation after the deadline date. All ads received after the deadline will be printed in the following issue of the appropriate journal(s).
For more information about classified advertising, call Liese Dixon at 800-920-1695 (toll-free) or 267-685-2491. For information about placing a display ad in Market Showcase, call Linda Costantini at 800-426-9119, ext. 52422 (toll-free), or 267-685-2422.
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A
B
C
A Hole in the Ace Submitted by Meagan Stange, Jefferson Animal Hospital, Louisville, Ky.
CE, A 2½-YEAR-OLD GERMAN SHEPHERD, presented to our clinic one morning with a small metal rod protruding from his eye (A). As far as the owner could tell, Ace had been hit with a blow dart sometime the night before. (The owner had removed a plastic cap from the end of the object before bringing the pet to the clinic.) On examination, approximately 5 cm (2 inches) of a metal, needle-like rod measuring about 0.5 mm in diameter was protruding from the center of the cornea. The eye appeared to be inflated, with a possible decrease in ocular pressure. Minimal bleeding was found in the anterior chamber. After the dog was sedated, radiographs revealed an 11.4-cm (4.5-inch), dense metal rod with a straight, needle-like sharp point that appeared to be embedded in bone behind the orbit (B and C). The doctor on duty removed the rod from the eye, placed two 6-0 absorbable polyglactin 910 sutures across the puncture hole in the cornea, inflated the globe with sterile fluid, and applied tobramycin drops and atropine ointment. Today, Ace seems to have only slight vision in the affected eye but otherwise is doing well.
A
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. 512
AUGUST 2008 | Veterinary Technician
www.VetTechJournal.com
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8dbea^VcXZ WHAT FEEDS YOU?_____________________ . Let’s face it, pet owners love to give their dogs treats. But when you prescribe a therapeutic diet for a pet, giving the wrong treats can compromise compliance. That’s why we’ve developed a line of healthy, palatable canine treats to complement our therapeutic diets. So you can keep them on track by helping pet owners treat responsibly.
Now with 48% fewer calories per biscuit.*
For sensitive GI tracts and food allergies.
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Compliance has never tasted so good. 1-800-222-VETS www.purinavets.com | user name: purinavets | password: nutrition
*When compared to Purina Veterinary Diets® Lite Biscuits brand Canine Treats Trademarks owned by Société des Produits Nestlé S.A., Vevey, Switzerland
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Now! More Cardell® Monitor choices!
Model 9500HD
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These additions to the Cardell Monitor line have the same “best-in-class” components like the world leading blood pressure technology and Nellcor OxiMax® pulse oximetry. Ask your distributor about them today or call us at 866-447-4276 (866-Hi Sharn).
Compact Model 9500HD
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• Add mainstream CO2 anytime • Free esophageal ECG (introductory offer) • World class BP, SpO2, ECG, respiration, temperature technology • High definition, full color 7” screen • PC connectivity & networking capable on Model 9503 • 4-channel waveform display • Built-in printer • Graphical trend history • 5-minute ECG trends
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The
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12950 N. Dale Mabry Hwy., Tampa, Florida 33618 813-962-6664 or Toll Free 1-866-Hi Sharn (447-4276) ©2008 SHARNVET, INC. 030208A
www.SharnVet.com
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